• Incentive: All eligible professionals [PDF](physicians and other clinicians who submit Part B claims to Medicare) must participate in PQRS. Eligible professionals will no longer be eligible for bonus payments based on successful PQRS reporting.
  • Penalty: Eligible professionals (physicians and other clinicians who submit claims to Medicare) who do NOT participate in 2016 PQRS will receive a negative payment adjustment of 2 percent on Medicare Part B payments in 2018.

Additional Penalties under the Value-Based Modifier: CMS will expand the Value-Based Modifier to all solo practitioners and eligible professionals in groups of two or more in 2018, including non-physician eligible professionals (for the 2016 performance year). Solo practitioners and physicians in groups of two to nine eligible professionals will be subject to an additional negative payment adjustment of 2 percent under the value-based modifier in 2018 if they do NOT successfully participate in 2016 PQRS. Groups of 10 or more eligible professionals will be subject to an additional negative payment adjustment of 4 percent under the value-based modified in 2018. Additional penalties may apply based on performance under the quality-tiering methodology applied to all physician eligible professionals in 2018.