Registry-based and QCDR-based Reporting Mechanisms

Physician Quality Reporting System (PQRS) (CMS-10276)

2015-2016_PQRS ImplementationGuide- Crosswalk.xlsx

Registry-based and QCDR-based Reporting Mechanisms

OMB: 0938-1059

Document [xlsx]
Download: xlsx | pdf
2015 (old version) 2016 (new version) Type of Change Reason for Change Burden Change
-- Updated program year to 2016 throughout Rev 2016 is the applicable program year No
-- Minor language and formatting updates throughout Rev Changes reflect PQRS naming conventions No
-- Added process for determining group size for participation via PQRS group practice reporting option. Insertion Clarifies the process for determining size of PQRS group practices No
Reporting Electronically Using an EHR (section within 2015 Implementation Guide) Removed section for 2016 Deletion This information is included in other educational documentation for PQRS. It was removed from the Implemenation Guide in an effort to simplify the document. No
Reporting via Qualified Registry
(section within 2015 Implementation Guide)
Removed section for 2016 Deletion This information is included in other educational documentation for PQRS. It was removed from the Implemenation Guide in an effort to simplify the document. No
Reporting via Qualified Clinical Data Registry (QCDR)
(section within 2015 Implementation Guide)
Removed section for 2016 Deletion This information is included in other educational documentation for PQRS. It was removed from the Implemenation Guide in an effort to simplify the document. No
Reporting via the GPRO Web Interface
(section within 2015 Implementation Guide)
Removed section for 2016 Deletion This information is included in other educational documentation for PQRS. It was removed from the Implemenation Guide in an effort to simplify the document. No
CAHPS for PQRS - CMS-Certified Survey Vendor
(section within 2015 Implementation Guide)
Removed section for 2016 Deletion This information is included in other educational documentation for PQRS. It was removed from the Implemenation Guide in an effort to simplify the document. No
Reporting Data via Claims
(section within 2015 Implementation Guide)
Removed section for 2016 Deletion This information is included in other educational documentation for PQRS. It was removed from the Implemenation Guide in an effort to simplify the document. No
Glossary of Terms Glossary of Terms Rev Glossary was updated to relfect current terms, definitions, and resources for 2016 PQRS. No
Appendix B: Decision Trees - 2015 PQRS Reporting/Participation for Avoiding the 2017 Negative Payment Adjustment Appendix B: Decision Trees - 2016 PQRS Reporting/Participation for
Avoiding the 2018 Negative Payment Adjustment
Rev Updated program year and payment adjustment year in all Appendix B images No

Choose Claims-Based Reporting Options to Avoid 2018 PQRS Negative Payment Adjustment Rev Condensed reporting criteria - information conveyed is the same but has been simplified. No

Choose Qualfied Registry Reporting Options to Avoid 2018 PQRS Negative Payment Adjustment Rev Condensed reporting criteria - information conveyed is the same but has been simplified. No

Choose Electronic Reporting Using an EHR Options to Avoid 2018 PQRS Negative Payment Adjustment Rev Formatting, language and other minor updates were made to this visual. No
I want to participate in 2015 PQRS to avoid The 2017 negative payment adjustment - Group Practice Reporting Option to avoid 2017 PQRS negative payment adjustment N/A Deletion The two images associated with the group practice reporting option in the 2015 Implementation Guide were replaced with more descriptive images for 2016. No
N/A Group Practice Reporting Option to Avoid 2018 PQRS Negative Payment Adjustment (pg. 24 of 2016 Implemenation Guide) Insertion This image was created to outline the various reporting mechansims available under the group practice reporting option for 2016. Yes - this image includes reporting CAHPS for PQRS in conjunction with the other available mechanisms for 2016. Additionally, QCDR was added as a reporting mechanism for PQRS group practices (as outlined in the Federal Register).
N/A Qualified Registry Reporting for Group Practices Insertion The information in this image was previously part of one image that outlined all mechanisms and requirements for PQRS group practices in 2015. In order to simplify, the registry and registry + CAHPS for PQRS requirements were moved to a standalone image. No
N/A Direct EHR Product that is CEHRT or EHR Data Submission Vendor Product that is CEHRT Insertion The information in this image was previously part of one image that outlined all mechanisms and requirements for PQRS group practices in 2015. In order to simplify, the EHR and EHR + CAHPS for PQRS requirements were moved to a standalone image. No
N/A Qualified Clinical Data Registry Reporting for Group Practices Insertion New for 2016, this image details the QCDR participation for PQRS group practices. Group size requirements and reporting requirements are detailed. This image also outlines QCDR + CAHPS for PQRS reporting requirements. Yes - QCDR was made available to PQRS group practices for 2016 (as outlined in the Federal Registrer).
N/A GPRO Web Interface Insertion The information in this image was previously part of one image that outlined all mechanisms and requirements for PQRS group practices in 2015. In order to simplify, the Web Interface and Web Interface + CAHPS for PQRS requirements were moved to a standalone image. No
2015 Program Reporting Options N/A Deletion The 2015 Implementation Guide included a section of text that followed the Decision Trees in Appendix B. The text contained the same information as the visuals and was removed in an effort to simplify the document. No
Appendix C: Satisfactory Reporting via Claims Scenario N/A Deletion The Satisfactory Reporting via Claims scenario was removed because a separate document was created describing this process in more detail. No
Appendix D: CMS-1500 Claim PQRS Example Appendix D: CMS-1500 Claim PQRS Example Rev The 1500 claim example was updated for 2016 including; revising to include applicable measures, updated coding, updated language and terminology. No
N/A Appendix E: CMS-1450 Claim PQRS Example Insertion The 1450 claim example was added to the 2016 Implemenation Guide to provide EPs under CAH Method II an example of how to report quality-data codes. No
Appendix E: PQRS EHR Process Appendix F: EHR Process (Data Flow) Rev Updated language and terminology. Specific reporting requirements were removed for 2016 since those are detailed in the Decision Tress within the same document. No
Appendix F: PQRS Registry Process Appendix G: Registry Process (Data Flow) Rev Updated language and terminology. Specific reporting requirements were removed for 2016 since those are detailed in the Decision Tress within the same document. No
Appendix G: PQRS GPRO Web Interface Process Appendix H: PQRS GPRO Web Interface Process (Data Flow) Rev Updated language and terminology. Specific reporting requirements were removed for 2016 since those are detailed in the Decision Tress within the same document. No
Appendix H: QCDR Process Appendix I: QCDR Process (Data Flow) Rev Added PQRS group practices to the data flow, updated language and terminology, specific reporting requirements were removed for 2016 since those are detailed in the Decision Tress within the same document (pg.38) Yes - QCDR was made available to PQRS group practices for 2016 (as outlined in the Federal Registrer).
Appendix I: PQRS Claims-Based Process Appendix C: PQRS Claims-Based Process (Data Flow) Rev Updated to reflect appropriate payment adjustment year. No






























































































































































































































































































































































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