PQRS Changes in 2016 Physician Fee Schedule Final Rule

December 4, 2015
Health Policy

On October 30, the Centers for Medicare & Medicaid Services (CMS) issued the final rule that updates the payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after January 1, 2016. The rule changes several of the quality reporting initiatives associated with MPFS payments, including the Physician Quality Reporting System (PQRS).

Major highlights include:

  • Individual eligible professionals and group practices that meet the criteria for 2016 PQRS satisfactory reporting/participation will avoid the PQRS negative payment adjustment in 2018
  • PQRS group practices can participate in 2016 PQRS via the Qualified Clinical Data Registry mechanism in 2016
  • There are 281 measures in the PQRS measure set and 18 measures in the group practice reporting option web interface for 2016

The 2018 PQRS payment adjustment is the last adjustment that will be issued under the PQRS. For more information about participating in PQRS in 2016, visit the PQRS website.