2016 PQRS MAV and Clusters

When reporting individual PQRS measures with a registry,  a provider reporting individually or a group practice participating in the Group Practice Reporting Option (GPRO) is expected to report 9 measures across 3 different domains for at least 50% of applicable Medicare patients. The Centers for Medicare & Medicaid Services (CMS) recognizes that a limited number of eligible professionals may not be able to identify 9 measures across 3 domains that are applicable to their practice.

Eligible professionals or group practices that submit less than 9 measures or less than 3 NQS domains will be subject to MAV (Measure-Applicability Validation).

CMS created Clusters of Clinically Related Measures that are used during the MAV process to evaluate the measures that a provider or GPRO has reported. To pass the MAV,  a provider or a group practice participating in the Group Practice Reporting  Option (GPRO) needs to report ALL the individual PQRS measures INSIDE a cluster of Clinically Related Measures.
For example, a dermatologist reporting the Melanoma PQRS cluster (137, 138, 224) could avoid the 2018 PQRS Payment Adjustment as long as the provider reports all three measures successfully for at least 50% of applicable patients.

Additionally at least one cross-cutting measure must be satisfactorily reported for those individual providers or group practices who bill Medicare for face-to-face encounters.

The list of all 2016 clinically related measures clusters can be found at:

 

More info about the MAV process can be found at:

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