PQRI: Medicare Advantage Plans May Disburse PQRI Bonuses

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article summarizes CMS comments from a national provider call about the Physician Quality Reporting Initiative (PQRI). It explains the general circumstances under which Medicare Advantage plans may pass along PQRI bonus payments, reports on corrections to previously issued PQRI adjustment payments, and notes timing and participation information for the next PQRI reporting cycle. The content is relevant to physicians, billing staff, and reimbursement professionals tracking CMS quality reporting updates.

Why This Topic Matters

Providers and billing teams need to know how CMS is handling PQRI bonus payments, especially where Medicare Advantage coverage and payment adjustments are involved. The article also highlights timing and administrative details that can affect whether practices receive expected incentive payments.

What You Will Learn

  • How CMS described PQRI bonus payment handling in Medicare Advantage contexts.
  • What CMS reported about adjustments to previously issued PQRI payments.
  • When the next PQRI reporting cycle was expected to begin.
  • Where CMS directed readers for additional program information.

Who Should Read This

  • Physicians
  • Eligible professionals
  • Medical billing staff
  • Coding and reimbursement staff
  • Practice administrators

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