February 15 quality reporting deadlines approaching

The deadline for the following quality reporting components is Friday, February 15.

  • Keeping provider lists up to date

It is important for practices to routinely update provider lists in the NACOR Dashboard. AQI's NACOR uses the list as the record of truth for CMS data submission, as well as Provider Reconciliation/Invoicing. Your practice should make sure the following are correct:


Provider NPI

Report to CMS Status

While reconciling provider lists, make sure all NPIs are assigned the proper provider type (MD-Anesthesia, CRNA, DO, AA, SRNA, Resident, etc.). AQI has discovered that Residents and SRNAs are being listed as "Other." All providers with a provider type of "Other" will have their data submitted to CMS.

This step-by-step guide will help in the updating process. For practices enrolled in individual reporting, remove providers who have retired or left your practice. For those practices enrolled in group reporting, remove provider who have retired or left your practice prior to January 1, 2018. Any providers who worked for your practice during the 2018 reporting year will be included in 2018 CMS data submissions.

  • Report to CMS for this provider elections

For practices that have elected Group Reporting for 2018, the Report to CMS field on the provider list in the NACOR dashboard is defaulted to "Yes." Practices do not have the ability to edit this field because, according to CMS, "a group electing to submit data at the group level will have its performance assessed and scored across the TIN, which could include items and services furnished by individual NPIs within the TIN who are not required to participate in MIPS. For example, excluded clinicians are part of the group, and therefore, would be considered in the group's score." Failing to report on all the group's clinicians could adversely impact the group's score.

  • Attesting to 2018 Improvement Activities

All NACOR participants can claim IA_PSPA_1: Participation in an AHRQ-listed patient safety organization as a medium-weighted activity worth 10 points.

For both individual and group reporting options, clinicians can attest to 2018 Improvement Activities using the provider list in the NACOR dashboard. In this step-by-step tutorial, clinicians learn how to select the Improvement Activity to which they will attest.

  • Final Data Submission Deadline - December 2018 data and any corrected data files


Contact your AQI account manager or email askaqi@asahq.org with questions regarding deadlines.

2019 XML schema changes

Due to the transition to ePreop data warehousing services in July, no XML schema changes will be announced until April 2019. Between Jan 1, 2019 and April 2019, please continue to use the 2018 XML format. In April 2019 AQI plans to extend the XML format to include additional optional fields. We anticipate these changes will not affect most and will only require a change in version number from 2018 to 2019. The XML schema will be extended to accommodate additional values, pending revision of the NACOR Data Definitions and may include terms for the Society for Ambulatory Anesthesia (SAMBA), the American Society of Dentist Anesthesiologists (ASDA) and ePreop's Anesthesia Valet.

From Jan 1, 2019 through July 1, 2019, data submissions may use the 2018 XML format for reporting 2019 MIPS and QCDR measures. After the 2019 XML changes have been released in April, AQI will accept either the 2018 or 2019 format until July 1, 2019 after which the 2019 version will only be accepted. Please visit www.aqihq.org/vendorsQCDRHelp.aspx for up-to-date information.

AQI posts 2019 QCDR measure specifications

CMS has approved AQI's QCDR measures for 2019 and AQI has posted the 2019 QCDR Measure Specifications booklet. The booklet includes:

  • New QCDR measures for reporting in 2019
  • A list of measures CMS removed
  • A list of changes to measure specifications from 2018 to 2019

If you have any questions, please email AskAQI@asahq.org

Review your NACOR Dashboard

Remember to review your 2018 quality reports in the NACOR dashboard. Reviewing reports helps identify measure gaps and monitor providers’ performances in meeting 2019 reporting requirements. Corrected data files for January through November data were due Thursday, January 31. December data files are due on Friday, February 15. For more information, email askaqi@asahq.org.


2019 Resources

2019 NACOR fees (PDF)

2019 QCDR Measure Specifications (PDF)

2018 MACRA MIPS Information

Register for 2018 NACOR quality reporting

2018 NACOR pricing

2018 NACOR Data Definitions

2018 QCDR Measure Booklet

2018 Recommended Improvement Activities

NACOR News Library

Read past issues of AQI's NACOR News.

Office Hours FAQs

Question: If a provider has left the practice half way through the year - does the practice need to report the provider's cases?

If the practice is reporting as a group and the provider performed cases in 2018, the practice needs to be reporting 60% of all eligible cases for that provider regardless if they are still at the practice or not as CMS is evaluating the data at the TIN level not the individual NPI. If the practice is individually reporting, the data will follow the provider's NPI.

Question: In regards to the reporting year on the AQI website it state to submit 60% of eligible cases and we understand it is not pick your pace but does this mean 60% of 2018 cases? Can you elaborate?

The 2018 MIPS reporting requirement is to report on 60% of the denominator eligible cases for 6 measures including 1 outcome measure for the 12 month reporting period (1/1/2018 - 12/31/18). For example, If your practice is reporting MIPS 76 - Prevention of Central Venous Catheter (CVC - Related Bloodstream Infections and places 75 central lines during 2018 your practice would need to report on 45 cases which is 60% of the eligible cases.

Question: Is it possible for all providers in a practice to be non-MIPS eligible and not required to submit data as individuals, but are eligible as a group?

Yes if the individual providers do not meet the 2018 MIPS participation criteria (billed $90,000 or less in Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare secondary Payer) and have 200 or fewer Medicare Part B FFS beneficiaries) the practice can be MIPS eligible as a group if the group has billed $90,000 or more in PFS services furnished to Medicare Part B beneficiaries and have 200 or more Medicare Part B beneficiaries.