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Physician Quality Reporting System (PQRS)

The Physician Quality Reporting System (PQRS) was created in 2007 by Medicare to develop a baseline for the way that 200 medical conditions are treated in several different contexts, i.e., Measures (Quality Data Codes), Domains, and Cross-Cutting Measures (screening tools).  The goal is to reduce costs.  LCSWs who are Medicare providers must submit PQRS data in 2015 or face a reimbursement penalty in 2017; all penalties occur two years after data is submitted.  Required data will change every year. Resources on this page will help LCSWs understand the PQRS.

PQRS Glossary

Measures – the areas of medical treatment that are used to report PQRS data

Quality Data Codes (QDCs)– the codes that are reported on the CMS-1500 (02/12) and to registries for measures

Domains– 6 general areas to which the measures are assigned

Clusters–14 groups of related measures that do not apply to LCSWs in 2015

Cross-Cutting Measures– screening tools that meet the requirements of most PQRS measures for mental health - (for adults) and (for children and adolescents). 

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