Payment Issuance For Successful Participants In 2010 Medicare PQRI

The eligible professionals who met the criteria for successful reporting of PQRI (name changed to PQRS in 2011) will receive incentive payments for the 2010 Medicare Physician Quality Reporting Initiative (PQRI). The distribution of 2010 payments is scheduled to be completed by September 30, 2011.

How can I find details about my incentive payment, such as type and reporting year?

Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remit.

In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year.

Electronic Remittance Advice for PQRS: For the 2010 PQRI incentive payments, the 4-digit code is PQ10. This code will be displayed on the electronic remittance advice along with the LE indicator. Eligible professionals will see LE to indicate an incentive payment, along with PQ10 to identify that payment as the 2010 PQRI incentive payment. Additionally, the paper remittance advice will read, “This is a PQRI incentive payment.” The year will not be included in the paper remittance.

Electronic Remittance Advice for ERx: For the 2009 eRx incentive payments, the 4-digit code is RX09. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX09 to identify that payment as the 2009 eRx incentive payment.