CAP for PQRS

Register Now to Avoid 2016 Penalty

The AOA's Clinical Assessment Program (CAP) for the Physician Quality Reporting System (PQRS) can help you earn a potential 0.5%  incentive payment through the PQRS and avoid a 2% penalty in 2016. The AOA developed the CAP for PQRS to provide physicians with an opportunity to receive enhanced payment from CMS and understand how patients are doing using evidence-based process and outcome measures.  

Reporting Options

You have four options to report PQRS depending on your type of practice:

  • Individual Provider

  • Group Practice reporting as Individuals

  • Group Practice reporting as GPRO

  • Member of an ACO

Before Starting, Consider:

1. Is your billing department already reporting PQRS data on your behalf?

If so, you don't need to participate in CAP for PQRS; you've already fulfilled the PQRS reporting requirement, so there's no need to submit your data a second time.

2. Do you have an EHR?

If you do, find out whether your EHR system can submit PQRS data for you. If it can, you don't need to participate in the CAP for PQRS.

3. Are you participating in the EHR Incentive Program (Meaningful Use)?

In 2014, the PQRS and EHR Incentive Programs have become more aligned. This means if you have a qualified EHR and use this method to report 2014 PQRS, you will also meet the CQM requirement for the  EHR Incentive Program, also known as Meaningful Use. Note that you will still need to meet the other meaningful use objectives.

4. Are you part of an accountable care organization (ACO)? 

If so, you will not be able to report PQRS using a registry. Please contact your ACO representative for more information.

Participating in the CAP for PQRS

To get started you will need:
  • Your AOA ID and password to log in.

  • Your individual personal National Provider Identifier (NPI) and your Tax Identification Number (TIN) that you use when you bill Medicare. Failure to use your correct NPI or TIN will prohibit you from receiving a bonus incentive and you will also face a 2% penalty in 2016.

  • Credit card for payment.

Eligible professionals can only choose to participate in one measure group per reporting year, and there is only potential to receive one bonus incentive per reporting year. CMS has expanded the number of measure groups to 25, which greatly expands your opportunity to participate in the program. The AOA CAP for PQRS offers all 25. Please note that there are changes and updates to some of the measure groups this year.

In addition to the measure group option, we are offering the individual measure reporting option. There are 24 measure sets from which to choose. For Individual Measures reporting, you must report on 50% of your Medicare Part B FFS patients that are eligible for a minimum of nine individual measures across three National Quality Strategy (NQS) domains. All patients reported must have been seen during the 2014 calendar year.

Cost

  • The cost for AOA members is $199.

  • The cost for non-members is $299. This pricing applies to non-member DOs, MDs, nurse practitioners, physician assistants, certified nurse specialists, registered dieticians, and others.

Requirements and Deadlines

  • CMS requires all registries to conduct audits of participant data.

  • Please make sure that you keep track of your patient charts and match them with their computer-generated patient identifier numbers. This is the approximately eight-digit number that is automatically populated in the system when you add a new patient to the program.

  • We suggest you keep a list in an Excel file for easy access and also record this number in the patient chart.

  • All data during the reporting period for 2014 must be submitted by Jan. 30, 2015, at 5 p.m. EST.

  • CMS payments for PQRS 2014 will be made in the fall of 2015.

  • The AOA CAP for PQRS reserves the right to accept or decline any request for a refund. If you feel that a refund is due, please contact AOA CAP for PQRS at cap@osteopathic.org prior to Jan. 30, 2015, at 5 p.m. EST. Include the following information: your name, an email address you would like the confirmation sent to, and reason for refund. A confirmation email will be sent with information related to your refund, including whether such a refund has been approved. The amount to be refunded in the case where the refund has been approved will incur a $25 processing fee.​

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