Updated April 24, 2014
The Physician Quality Reporting System (PQRS) program is a voluntary reporting program that rewards physicians who successfully report data on quality measures to the Centers for Medicare and Medicaid Services (CMS). Physicians who do not participate in the program going forward are at risk for penalties applied to their Medicare Part B reimbursement.
The College of American Pathologists (CAP) and its Council on Government and Professional Affairs have dedicated considerable resources to enable pathologists to successfully participate in the program.
The CAP’s measure development efforts have focused on ensuring that members can benefit from public and private pay-for-performance programs.
Currently, five CAP-developed pathology measures exist in the 2013 PQRS. The CAP developed three additional measures in 2012 and currently, they are under consideration by CMS for inclusion in the 2015 PQRS. The CAP is committed to the continued development and maintenance of these measures for the benefit of CAP members.
Overview and Pathology Measures included in the 2014 PQRS (PDF, 424 K)
How to Participate in PQRS
Pathologists have several options for participating in PQRS. Your options depend on how you bill, the size of your practice, and whether your practice’s members want to report individually or as a group. The decision flow charts will help you determine which option is right for you.
Decision Flow Charts for 2014 PQRS Participation
The CAP advocates on behalf of pathologists regarding their options for PQRS reporting. While the CAP has created eight PQRS measures for pathologists, five of these measures are in the current PQRS program. CMS continues to raise the bar. In 2014, most specialties must report on a minimum of nine measures. But the CMS has assured the CAP—in writing—that pathologists who have fewer than nine measures will only need to report on applicable measures, and pathologists with no applicable measures will not face PQRS penalties in either 2015 or 2016.
The CAP has created a number of resources to help pathologists navigate the rules for PQRS, understand their options for reporting, and successfully report measures.
CAP Today Articles
Centers for Medicaid and Medicare Services (CMS)
Federal Registry Resources
- CMS Qualified Registries for the 2014 PQRS (PDF, 400 KB)
Note: Please use 2013 registry list as a guide for potential registries;
CMS will publish the official list of 2014 Qualified Registries in the summer of 2014.