PQRS & Measurement

To help clinical social workers in private practice understand how the PQRS program works, NASW has compiled a list of frequently asked questions by its members from phone calls, emails, and “An Hour With Private Practice: Questions and Answers.”

The purpose of this document is to inform clinical social workers who are Medicare providers of two major actions occurring at this time with the Physician Quality Reporting System (PQRS). The PQRS actions are for the reporting periods of 2015 and 2014.

The Centers for Medicare and Medicaid Services (CMS) has announced the PQRS 2015 qualified registries. Qualified registries are maintenance certification programs which have self-nominated and successfully completed a vetting process as specified by CMS to demonstrate their compliance with PQRS qualification criteria. They collect and submit PQRS quality measures data on behalf of clinical social workers and other Medicare providers. A fee may be charged.

To help clinical social workers in private practice understand how the PQRS program works, NASW has compiled a list of frequently asked questions by its members from phone calls, emails, and “An Hour With Private Practice: Questions and Answers.”

Since 2007, clinical social workers have been reporting the Physical Quality Reporting System (PQRS) which identifies measures used to improve the quality of care provided to Medicare beneficiaries. Because PQRS changes each year, clinical social workers should carefully review the reporting criteria for updates each reporting period.

In December 2014, clinical social workers who are Medicare providers may have received letters from the Centers for Medicare and Medicaid Services (CMS) which informed them of a penalty in 2015 for not using the Physician Quality Reporting System (PQRS) in 2013. PQRS was established by the Tax Relief and Health Care Act of 2006 (TRHCA). It is a voluntary quality reporting program for Medicare which was first implemented during the period of July 1, 2007 through December 31, 2007.