What is the Physician Quality Reporting System?
The Physician Quality Reporting System is a voluntary program that allows physicians and other healthcare professionals to report information to Medicare about the quality of care they provide to people with Medicare who have certain medical conditions. The 2006 Tax Relief and Health Care Act required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals who satisfactorily report data on quality measures for covered professional services provided to Medicare beneficiaries.
Who is Eligible to Participate in the Physician Quality Reporting System?
Professionals who are eligible to participate in the Physician Quality Reporting System include:
Medicare Physicians
- Doctor of Medicine
- Doctor of Osteopathy
- Doctor of Podiatric Medicine
- Doctor of Optometry
- Doctor of Oral Surgery
- Doctor of Dental Medicine
- Doctor of Chiropractic
Practitioners
- Physician Assistant
- Nurse Practitioner
- Clinical Nurse Specialist
- Certified Registered Nurse Anesthetist
- Anesthesiologist Assistant
- Certified Nurse Midwife
- Clinical Social Worker
- Clinical Psychologist
- Registered Dietitian or Nutrition Professional
- Audiologist (Hearing)
Therapists
- Physical Therapist
- Occupational Therapist
- Speech-Language Pathologist (Speech Therapy)
How Do Eligible Professionals Report Information?
To participate in the Physician Quality Reporting System, individual eligible professionals may choose to report information on individual Physician Quality Reporting quality measures or measures groups in any of the following ways:
- to the Centers for Medicare & Medicaid Services (CMS) on their Medicare Part B claims
- to a qualified Physician Quality Reporting registry, posted yearly
- to CMS via a qualified electronic health record (EHR) product
Note: The Physician Quality Reporting System requirements and measure specifications may change from year to year so it is important that eligible professionals use the correct program year documents.
For the Physician Quality Reporting System in 2010, Medicare selected over a hundred different quality measures that physicians and other healthcare professionals could report on that represent the type of care that they provide to their patients. Physicians and other healthcare professionals chose which measures they wanted to report to Medicare. Some examples include:
- Number of patients who had symptoms of a heart attack and were given aspirin when they arrived at the hospital.
- Number of female patients over age 65 who had a bone density screening for osteoporosis.
- Number of patients with diabetes who had high blood sugar levels.
This information helps physicians, other healthcare professionals, and Medicare learn about the quality of care given to people with Medicare and to find ways to improve that care.
How Do I Know If a Physician or Healthcare Professional Participated in Medicare’s Physician Quality Reporting System?
Physicians and other healthcare professionals who chose to take part in Medicare's Physician Quality Reporting System and reported quality measure information satisfactorily for the year 2010 will have an indicator on their profile page.
Download the list of eligible professionals who chose to take part in Medicare's Physician Quality Reporting System and reported quality measure information satisfactorily for the year 2010.
Eligible professionals who are part of a group practice may also have the option to report Physician Quality Reporting System measures as a group, instead of as an individual.
Download the list of group practices who chose to take part in Medicare's Physician Quality Reporting System Group Practice Reporting Option (GPRO) and reported quality measure information satisfactorily for the year 2010.