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CMS-1403-FC
TABLE 11: Final 2009 PQRI Claims-Based Reporting Options
for Individual Measures
Reporting
Mechanism
Claims-based
reporting
Reporting Criteria Reporting Period
At least 3 PQRI measures, or 1-2 measures
if less than 3 apply to the eligible
professional, for 80 percent of applicable
Medicare Part B FFS patients of each
eligible professional.
January 1, 2009 –
December 31, 2009
ii. Satisfactory Reporting of Data on Quality Measures and
Reporting Periods for Measures Groups, Through Claims-Based
Reporting and Registry-Based Reporting
As described in the CY 2009 PFS proposed rule, section
101(c)(5)(F) of the MIEA-TRHCA, as added by the MMSEA and
redesignated by the MIPPA as section 1848(m)(5)(F) of the
Act, requires that the Secretary establish alternative
reporting periods and alternative criteria for
satisfactorily reporting groups of measures. In
establishing these alternatives, we have labeled these
groups of measures “measures groups.” We define “measures
groups” as a subset of PQRI measures that have a particular
clinical condition or focus in common. The denominator
definition and coding of the measures group identifies the
condition or focus that is shared across the measures
within a particular measures group.
For the 2009 PQRI, we proposed to expand the available
measures groups to a total of nine measures groups. We
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