Physician Quality Reporting System
What Neurosurgeons Need to Know for 2015
Since 2007, the Physician Quality Reporting System (PQRS) has been a voluntary federal program, offering
Medicare incentive payments to physicians who reported quality measure data to the Centers for Medicare
and Medicaid Services (CMS). However, the Affordable Care Act (ACA) requires that CMS phase out incentive
payments. Physicians and other eligible professionals (EPs) will now be subject to increasing penalties for
failure to satisfy PQRS reporting requirements. As such, 2014 was the LAST year to qualify for a PQRS
incentive payment. Beginning in 2015, the program transitions to penalties only. Neurosurgeons who
do not satisfy the program’s requirements in 2015 will be paid two percent less than the Medicare Physician
Fee Schedule (MPFS) amount for services rendered from Jan.1, 2017 to Dec. 31, 2017.
CMS also will use the 2015 reporting year to determine a separate Value-Based Payment Modifier (VM),
which will affect payments to all physicians, regardless of group practice size, in 2017. The VM is tied to
satisfactory PQRS participation, and CMS uses PQRS quality measures to calculate additional, and
increasingly larger, performance-based payment adjustments under the VM. Click here for more information
about the VM.
As a result of these and other penalty-driven programs — including the separate Medicare and Medicaid
Electronic Health Records (EHR) Incentive Programs (known as meaningful use) — nearly 10 percent of
neurosurgeons’ Medicare payments will be at risk over the coming years.
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