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2010 PQRI Group Practice Reporting Option

In accordance with section 1848(m)(3)(C) of the Social Security Act (the Act), CMS is introducing a new group practice reporting option (GPRO) for the PQRI beginning with the 2010 PQRI. Group practices that satisfactorily report data on PQRI measures for a particular reporting period are eligible to earn a PQRI incentive payment equal to a specified percentage of the group practice's total estimated Medicare physician fee schedule allowed charges for covered professional services furnished during the reporting period.

For the 2010 PQRI, the incentive payment is equal to 2% of the group practice's total estimated Medicare fee schedule allowed charges for covered professional services furnished during the 2010 reporting period. As required by the Act, an individual physician in a selected group practice cannot earn PQRI incentive payments both as an individual and as a member of the group practice. Once a group practice (TIN) is selected to participate in the GPRO, this is the only method of PQRI reporting available to the group and all individual NPIs who bill Medicare under the group's TIN.

GPRO Requirements for Submission of 2010 PQRI Data. To participate in the 2010 PQRI GPRO, a group practice must comply with certain requirements, submit a self-nomination letter to CMS, and be selected to participate in the 2010 PQRI GPRO. The GPRO requirements and instructions for submitting the self-nomination letter can be found in the document.

2010 PQRI Group Practice Reporting Option Measures and Group Practice Reporting Option Narrative Measure Specifications. For purposes of determining whether a group practice satisfactorily submits PQRI quality measures data for 2010, each group practice selected to participate in the 2010 PQRI GPRO will be required to report 26 quality measures. A list of the 26 2010 PQRI GPRO measures can be found in the "2010 PQRI GPRO Disease Modules and Preventive Care Measures" document. A description of each of the 26 measures can be found in the "2010 PQRI GPRO Narrative Measure Specifications" document.

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