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It is Not Too Late to Participate in the PQRI

Coding Corner

The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.

It is Not Too Late to Participate in the PQRI
For 2010, eligible professionals who satisfactorily report Physician Quality Reporting Initiative (PQRI) measures for the 6-month reporting period beginning July 1 will become eligible to receive a PQRI incentive equal to two percent of their total Medicare Part B allowed charges for services performed during this period. You can participate in the PQRI by following one of the following options:

  • Claims-based reporting of individual measures for 80 percent or more of applicable patients on at least three individual measures or on each measure if less than three measures apply;
  • Claims-based reporting of one measures group for 80 percent or more of applicable Medicare Part B fee-for-service patients of each eligible professional (with a minimum of eight patients);
  • Registry-based reporting of at least three individual PQRI measures for 80 percent or more of applicable Medicare Part B fee-for-service patients of each eligible professional; or
  • Registry-based reporting of one measure group for 80 percent or more of applicable Medicare Part B fee-for-service patients for each eligible professional (with a minimum of eight patients).

Additional information is available at www.cms.gov.