Answer_Book / Quality_Reporting_Initiatives / PQI Old sections / How_Medicare_pays_you

Why This Topic Matters

It helps readers understand a Medicare payment-related quality reporting option that may affect eligibility for a bonus and the general reporting process tied to PQRI participation.

Article Sections

1. Alternative claims-based PQRI reporting

   Introduces the alternative Medicare quality reporting pathway and summarizes the broad measure-group categories included in the program.

2. How the alternative reporting approach works

   Explains the high-level structure of reporting through claim submissions for a sequence of qualifying patients and the general timing of the reporting period.

3. Using measure groups on claims

   Describes the claim-based workflow for initiating reporting with a group code and continuing with measure reporting across patients in the group.

4. Clinical example

   Provides an illustrative example of how one measure group may be selected and how reporting may be supported when another clinician performed part of the underlying service.

5. Registry-based PQRI reporting

   Summarizes the article’s discussion of data registries, CMS participation selection, and the general status of registry reporting availability.