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Now Available: Updated 2023 CMS QRDA III Sample Files and Schematron and 2024 CMS QRDA III Sample Files for Eligible Clinician Programs

The Centers for Medicare & Medicaid Services (CMS) has released an update to the 2023 CMS Quality Reporting Document Architecture (QRDA) Category III Sample Files and Schematron and 2024 CMS QRDA III Sample Files for Eligible Clinician Programs. The 2023 and 2024 CMS QRDA III Implementation Guides outlines requirements for eligible clinicians to report eCQMs for the calendar year 2023 and 2024 performance periods respectively, for these programs:

  • Quality Payment Program: Traditional Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs), APM Performance Pathway (APP), and MIPS Value Pathways (MVPs)
  • Primary Care First (PCF)

Changes to the 2023 CMS QRDA III Sample Files

  • Corrected CMS138v11 to include denominator exclusion (DENEX) instead of denominator exception (DENEXCEP) in these sample files:
    • 2023MIPSAPMEntityMVPSampleQRDA-III 
    • 2023MIPSSubgroupMVPSampleQRDA-III
    • 2023MIPSGroupSampleQRDA-III
  • Removed CMS147v12 from these sample files that are not indicated as for MVP submission:
    • 2023MIPSAPPGroupSampleQRDA-III
    • 2023MIPSGroupSampleQRDA-III

Changes to the 2023 CMS QRDA III Schematron

  • Corrected the misplaced closing parenthesis in the assertion test for CONF:4526-18177_C01.

Changes to the 2024 CMS QRDA III Sample Files 

  • Corrected CMS138v12 to include denominator exclusion (DENEX) instead of denominator exception (DENEXCEP) in these sample files:
    • 2024MIPSAPMEntityMVPSampleQRDA-III 
    • 2024MIPSSubgroupMVPSampleQRDA-III
    • 2024MIPSGroupSampleQRDA-III

Additional QRDA-Related Resources: 

Find additional QRDA-related resources, current and past implementation guides on the Electronic Clinical Quality Improvement (eCQI) Resource Center QRDA page. For questions related to this guidance, the QRDA IGs, 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.

 

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Last Updated: Feb 21, 2024