November 04, 2010
Incentive Payment Update for 2009 Physician Quality Reporting Initiative (PQRI)
The following update was provided by the Centers for Medicare and Medicaid Services (CMS).
Incentive payments for the 2009 Physician Quality Reporting Initiative (PQRI) are available this fall for eligible professionals who meet the criteria for successful reporting. Carriers and Medicare Administrative Contractors (MACs) will begin processing and distributing 2009 PQRI incentive payments on October 25, 2010. Distribution of 2009 PQRI incentive payments is scheduled to be completed by November 12, 2010.
Remember that PQRI incentives earned by individual participating physicians and other eligible professionals are paid as a lump-sum to the Taxpayer Identification Number (TIN) under which the professional’s claims were submitted. It is then up to the TIN to decide how to distribute the incentive within the practice.
Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remit. In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2009 PQRI incentive payments, the 4-digit code is PQ09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with PQ09 to identify that payment as the 2009 PQRI incentive payment. Additionally, the paper remittance advice will read, “This is a PQRI incentive payment.” The year will not be included in the paper remittance.
2009 PQRI feedback reports will be available on the Physician and Other Health Care Professionals Quality Reporting Portal starting the second week of November. TIN-level reports on the Portal require an Individuals Authorized Access to CMS Computer Services (IACS) account. Participants may also contact their Carrier/MAC to request individual NPI-level reports via an alternate feedback report fulfillment process; visit cms.gov for details. Watch for additional feedback report information from CMS.
Who to Contact for Questions?
If you have questions about the status of your PQRI incentive payment (during the distribution timeframe), please contact your Provider Contact Center. The Contact Center Directory is available on the CMS website.
Contact the QualityNet Help Desk with any of the following:
• PQRI Portal password issues
• PQRI/eRx feedback report availability and access
• PQRI-IACS registration questions
• PQRI-IACS login issues
The QualityNet Help Desk is available Monday through Friday from 7:00 a.m. – 7:00 p.m. CST at 1-866-288-8912 or via firstname.lastname@example.org. They can also assist with program and measure-specific questions.