​Physicians and other health care professionals who provide Medicare Part B Physician Fee Schedule (PFS) covered professional services need to be aware of negative payment adjustments being implemented in CY 2015. These payment adjustments include:

1. A negative 1.5 percent payment adjustment under the Physician Quality Reporting System (PQRS) for individual eligible professionals (EPs) who do not submit data on PQRS quality measures to CMS in 2013.
2. A negative 1 percent adjustment under the Value-Based Payment Modifier (VM) for physicians in groups of 100 or more EPs who submit claims to Medicare under a single tax identification number who fail to report under PQRS in 2013.

What Do Individual EPs need to do? Individual eligible professionals (EPs) can submit data through the traditional PQRS methods (claims, registry and EHR) to avoid the 2015 payment adjustment and potentially earn a 2013 incentive payment of 0.5%. Alternatively, to avoid the payment adjustment only, EPs can request that CMS calculate their quality data from administrative claims. EPs must register for the CMS-calculated administrative claims option by October 15, 2013.

To register for the CMS-calculated administrative claims option, EPs should use the instructions and information available in the Quick Reference Guide for Individual EPs.

What Do Group Practices Need To Do? For purposes of the PQRS and VM payment adjustments, group practices should first to identify how many EPs they have billing Medicare under their tax identification number. If the number of EPs in the group is under 100, the group is not subject to the value modifier for 2015. Groups with 2-99 EPs can still register to report under the PQRS Group Practice Reporting Option (GPRO) to avoid the 2015 PQRS payment adjustment and potentially earn a 2013 PQRS incentive payment of 0.5 percent, however it is not required. Groups with 100 or more EPs are required to register for purposes of avoiding a negative VM payment adjustment. Reporting options for group practices include the web-interface GPRO and registry. The reporting option available to the group will depend on the group size. Alternatively, to avoid payment adjustments only, groups can request that CMS calculate their quality data from administrative claims. Group practices must register and select their reporting method by October 15, 2013.

To register as a group practice and select a reporting method, group practices should use the instructions and information available in the Quick Reference Guide for Group Practices.

Resources - Additional information and resources are available on the PQRS Web site and the Physician Feedback/VM Self Nomination/Registration Web site. If you have questions, please contact the QualityNet Help Desk at (TTY ) or via . They are available Monday through Friday from 7:00 a.m. to 7:00 p.m. CT.