The 2019 CMS QRDA III Implementation Guide

Plus: Schematron, and Sample Files Are Now Available

The Centers for Medicare & Medicaid Services (CMS) has published the 2019 CMS Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample files.  The 2019 CMS QRDA III IG will help eligible clinicians and eligible professionals report electronic clinical quality measures (eCQMs), improvement activities, and/or promoting interoperability measures for the calendar year 2019 performance period.

The IG provides technical instructions for QRDA III reporting for the following programs:

  • Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs)

  • Comprehensive Primary Care Plus (CPC+)

  • Promoting Interoperability (PI)

The 2019 CMS QRDA III IG contains the following high-level changes from the 2018 QRDA III IG Version 2 (last updated July 27, 2018):

  • Increased alignment with its base standard, the HL7 QRDA III STU R2.1 IG

  • Now shows the template changes from the base HL7 QRDA III STU R2.1 IG only

  • Updated eCQM Universally Unique Identifiers (UUIDs) for the 2019 performance period eCQMs that were released on May 4, 2018. Please note, measures will not be available for 2019 reporting unless they are proposed and finalized through notice-and-comment rulemaking for the applicable program year.

The following changes are present in both the 2018 CMS QRDA III IG V2 (last updated July 27, 2018) and the 2019 CMS QRDA III IG:

  • The templates have been updated to report the performance period at the individual measure/activity level. The performance period under MIPS can be reported at the individual measure level for the MIPS quality measures and at the individual activity level for the MIPS improvement activities (IA), as defined by CMS, or the performance category level for Quality and IA performance categories. Performance period reporting for Promoting Interoperability (formerly Advancing Care Information) and CPC+ remains at the category level.

  • The addition of a new CMS program name code “MIPS_VIRTUALGROUP” to support MIPS virtual group reporting.

Additional QRDA-Related Resources: