Mastery of Breast Surgery Program

PHYSICIAN QUALITY REPORTING SYSTEM (FORMERLY PQRI)

What do I need to know about the program?

The Centers for Medicare & Medicaid Services (CMS) recently changed the name of the Physician Quality Reporting Initiative (PQRI) to the Physician Quality Reporting System (PQRS).  The 2011 PQRS comprises 200 quality measures (including both individual measures and measures that are part of a 2011 measures group).  To review the 2011 PQRS measure specifications manual go to  http://www.cms.gov/PQRI/15_MeasuresCodes.asp.

The Mastery of Breast Surgery Program was a qualified 2010 PQRI registry for the Perioperative Measures Group.  The Society is currently completing  the vetting process to become a 2011 PQRS qualified registry for  this measures group. The Perioperative Measures Group includes Physician Quality Reporting System Measures #20-23::

Measure #20- Perioperative Care: Timing of Antibiotic Prophylaxis-Ordering Physician
Measure #21- Perioperative Care: Selection of Prophylactic Antibiotic-First OR Second Generation Cephalosporin
Measure #22- Perioperative Care: Discontinuation of Prophylactic Antibiotics (Non-Cardiac Procedures)
Measure #23- Perioperative Care: Venous Thromboembolism (VTE) Prophylaxix (When Indicated in ALL Patients)
  • Eligible participants will receive incentive payments of 1 percent of the total estimated allowed charges for covered professional services under Medicare B for the 2011 reporting period. The incentive payment is scheduled to decrease to  .5 percent  for  2012-2014.  In  2015, if you don’t participate in the Physician Quality Reporting System, your reimbursement for your total allowed Medicare charges will be reduced by 1.5%.  In 2016 and thereafter, that reducation will grow to 2%.
  • The reporting period is from January 1-December 31, 2011
  • You must report on 30 unique Medicare Part B Fee For Service patients patients that meet the sample criteria for the Perioperative measures group.
  • Please note that all 30 patients must be Medicare patients which is a change from 2010 requirements.
  • In 2010, reporting on measures was sufficient, in 2011, adherence to measures will also be required..
  • The sample criteria for the Perioperative Measure Group includes lumpectomies and mastectomies but not open and percutaneous biopsies.(Applicable Codes: 19301, 19302, 19303, 19304, 19305, 19306, 19307)
  • All applicable measures within the group must be reported at least once for each patient in the 30 patient sample.
  • A report summarizing your performance and reporting rates will be available on the mastery website in the reports section.
  • Five percent of Mastery of Breast Surgery Program PQRS registry participants will be randomly selected for a review of their data.  If selected, a minimum of 30 patients will be reviewed.
  • Registry data (including personal health information of non-Medicare patients) may be inspected by CMS under their oversight authority.

Am I eligible to participate?

  • Do you perform at least 30 cancer surgeries (lumpectomies, mastectomies) on Medicare Part B Fee For Service patients per year?
  • Are you able to report on all applicable measures within the perioperative measures group at least once for each patient for a minimum of 30 patients?
  • Are you aware that as a Mastery of Breast Surgery Program PQRS registry participant you could be randomly selected for a review of your data?
  • Are you aware that registry data may be inspected by CMS under their oversight authority?
  • Are you aware that registry data may be inspected by CMS under their oversight authority?

If you have answered “yes” to the questions above, we encourage you to consider participating in this program.