By Rod Baird w/ clinical review by Bob Wells, MD CMD & Enrique Varela, MD CMD
Note to readers – the following article is written for understanding, not exact technical accuracy. Some elements of the PQRI program are ignored since they do not apply to the clinical situations covered by clinicians working for ECP.
PQRI is shorthand for The Physicians Quality Reporting Initiative, which was established by law and implemented by CMS in 2007. Clinicians who participate in the program, by reporting on selected ‘quality measures’, can earn an incentive payment. Currently that payment is set at 2% of allowable Medicare Charges. Each quality measure applies to a defined set of individuals. The criteria for the set include patient demographics (age, sex, and diagnosis) and Clinical parameters (type of treating provider and CPT code).