Clock and pen and paper

Accessing Your PQRS Feedback Report

Update: PQRS feedback reports for program year 2015 are now available (via CMS, 9/26/16). 2017 PQRS negative payment adjustment letters will be distributed shortly. Informal review will be open until November 30, 2016 at 11:59 P.M. EST.

What is PQRS?

The Physician Quality Reporting System (PQRS) is a program established and managed by the Centers for Medicare and Medicaid Services (CMS). The federal initiative aims to incentivize the reporting of quality data by individual Eligible Professionals (EPs) and group practices to Medicare by tying it to reimbursement rates. As all individual EP’s and group practices likely know by now, failing to satisfactorily report PQRS data will result in a negative payment adjustment under the Medicare Physician Fee Schedule (PFS). Those who reported satisfactorily for program year 2015 will avoid the negative 2% payment adjustment in 2017.

When will PQRS feedback reports for program year 2015 be available?

CMS announced that the PQRS feedback reports for program year 2015 will be available sometime this month, September 2016. These reports indicate whether or not your practice met all reporting requirements and if you’ll be subject to the future negative payment adjustment. Additionally, CMS announced that payment adjustment letters are projected to be sent in late summer or early fall. We recommend reviewing your feedback report as soon as made available to ensure you have enough time to properly review and request an informal review should your organization determine there was an error or CMS incorrectly assessed your practice. (Check back for updates!)

How to access your PQRS Feedback Report

To access your PQRS feedback report, you will need an Enterprise Identity Management System (EIDM) account, which can be established using the CMS Enterprise Portal at Once logged in, select the “PV-PQRS” tab and the “Feedback Reports” option to view your reports. The PQRS feedback can be viewed at three different levels: provider level, reporting mechanism level, and PQRS measure level. Detailed user guides can be found on the QualityNet portal page.

Quality Resource and Usage Reports

In addition to PQRS feedback reports, Quality and Resource Use Reports(QRURs) are also made available through the CMS Enterprise Portal. These reports show performance on all of the quality and cost measures at the Taxpayer Identification Number (TIN) level. These results are used by CMS to calculate the 2017 Medicare Value-Based Payment Modifier. CMS makes two types of QRURs available: the Mid-Year QRUR and the Annual QRUR. The Mid-Year QRUR (MY-QRURs) was made available in April 2016 and was for informational purposes only. Groups of 2 or more EPs and physicians who are subject to the 2017 Value-Based Payment Modifier can use the Annual QRUR to see how the value modifier will apply to the Medicare PFS physician payments. The QRUR is for informational purposes for all other groups and solo practitioners.

Requesting an informal review

If you believe that there was an error or a negative payment adjustment was applied incorrectly, you can request an informal review of the payment adjustment determination. If the review process concludes that satisfactory reporting actually occurred, CMS will reverse the application of the negative payment adjustment. Unfortunately, the informal review decision is final. CMS has no formal appeals process in place at this time.

To submit an informal review request, visit the Quality Reporting Communication Support Page (CSP). Informal review requests for 2015 may be submitted in the fall of 2016, and CMS will announce when this page is available. Remember, the informal review period is limited so review your feedback and get your requests in as soon as the page is available.

Schedule a Demo

September 21st, 2016 Categories: featured, MIPS Information

Tags: ,

Leave a Reply

Your email address will not be published.

Recent Posts

Trend: Patients seeking resources on scheduling COVID-19 vaccine in satisfaction surveys
March 17, 2021

An analysis of patient comments in the first two months of 2021 shows a trend in patients seeking information on how to schedule a COVID vaccine. Compared to the last two months of 2020, there has been a 301% increase in the mention of vaccines in free text patient comments. A limited vaccine supply has […]

MIPS Improvement Activities Best Practices
March 11, 2021

Clinicians and groups participating in the Merit-Based Incentive Payment System (MIPS) must earn 40 points for Improvement Activities (IA) in order to receive full credit for the IA performance category. High-weighted activities are worth 20 points, while medium-weighted activities are worth 10 points. Participants with special status will receive double points for each activity completed. […]

MIPS Extreme & Uncontrollable Circumstances Application Extended
March 5, 2021

The Centers for Medicare and Medicaid Services (CMS) has reopened the extreme and uncontrollable circumstances exception application for the 2020 performance year due to the COVID-19 public health emergency. Clinicians, groups, and virtual groups have until March 31, 2021 to submit an application requesting MIPS performance category reweighting. Data for the 2020 performance year that […]

respond to online reviews
Best Practice: Responding to Online Reviews
March 3, 2021

Over 80% of patients turn to Google when looking for a new healthcare provider. SurveyVitals’ online reputation tools have helped boost client Google reviews by 281%. While increasing your number of online reviews is essential for attracting new patients, it’s equally important to respond to these reviews appropriately. Patients are certainly reading online reviews, but […]