Now Available: Updated 2025 CMS QRDA III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinician Programs for the PFS Final Rule

The Centers for Medicare & Medicaid Services (CMS) has published the updated 2025 CMS Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample Files for Eligible Clinician Programs based on the 2025 Medicare Physician Fee Schedule (PFS) Final Rule released on November 1, 2024.

The updated 2025 CMS QRDA III IG outlines requirements for Eligible Clinicians (ECs) to report electronic clinical quality measures (eCQMs) for the Calendar Year (CY) 2025 EC quality reporting programs.

The updated 2025 CMS QRDA III IG contains these high-level changes based on the PFS Final Rule:

• Updates to support APM Performance Pathway (APP) Plus and Shared Savings Program Promoting Interoperability (SSP PI) reporting requirements:
  • Added new section 4.5 APP Plus to provide guidance for APP Plus submission
  • Added new section 4.6 Shared Savings Program Promoting Interoperability Reporting to provide guidance for SSP PI submission
  • Updated QRDA III templates with new conformance statements to support APP Plus and SSP PI
  • Added new CMS program name codes to support APP Plus and SSP PI
• Updated Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) Identifiers for the 2025 performance period
• Updated the following tables based on the PFS Final Rule:
  • Table 14: Universally Unique Identifier (UUID) List for MIPS CY 2025 Performance Period eCQM Specifications ECs
  • Table 16: Improvement Activities Identifiers for the MIPS CY 2025 Performance Period
• Table 17: Promoting Interoperability Objectives and Measures Identifiers for the MIPS CY 2025 Performance Period
• Table 18: Promoting Interoperability Attestation Statements Identifiers

The updated 2025 CMS QRDA III Schematron File contains these high-level changes:

• Updated the schematrons to support the updates to the QRDA III templates including new conformance statements added to support APP Plus and SSP PI

The updated 2025 CMS QRDA III Sample Files contains these high-level changes:

• Updated to align with the updated conformance statements
• Added new sample file for SSP PI reporting

Additional QRDA-Related Resources:

• To find out more about QRDA and eCQMs, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center
• For questions related to the QRDA IGs and/or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project
• See the QRDA Known Issues Dashboard for solutions under development for both QRDA I and III known technical issues. These known issues supplement the information in QRDA IGs and other supporting documents.