The Centers for Medicare & Medicaid Services (CMS) has published the Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinicians and Eligible Professionals Programs. The 2021 CMS QRDA III IG outlines requirements for eligible clinicians and eligible professionals to report electronic clinical quality measures (eCQMs), improvement activities (IA), and promoting interoperability (PI) measures for the calendar year 2021 performance period for these programs:

  • Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs)
  • Comprehensive Primary Care Plus (CPC+)
  • Primary Care First (PCF)
  • Medicaid Promoting Interoperability (PI)

The 2021 CMS QRDA III IG contains these high-level changes as compared with the 2020 CMS QRDA III IG:

  • Clarification of CPC+ QRDA III requirements in section 4.1
  • Preliminary QRDA III requirements for PCF have been defined
  • Updated eCQM universally unique identifiers (UUIDs) for the 2021 performance period

Note: A subsequent publication will follow the publication of the 2021 Physician Fee Schedule Final Rule to update MIPS eCQM, PI measures, and IA identifiers in Section 7 of this IG.

Changes to the 2021 CMS QRDA III Schematron:

  • Addition of conformance statements to support PCF requirements

Changes to the 2021 CMS QRDA III Sample Files:

  • Addition of a PCF QRDA III sample file

Additional QRDA-Related Resources:

Additional QRDA-related resources, as well as current and past implementation guides, are found on the Electronic Clinical Quality Improvement (eCQI) Resource Center QRDA page. For questions related to this guidance, the QRDA Implementation Guides or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.

About Author

Healthcentric Advisors
As the New England Quality Payment Program Support Center, Healthcentric Advisors assists New England-based physician and other eligible clinical practices to prepare for and participate in the new Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).