Now Available: Updated 2025 CMS QRDA I Implementation Guide (IG) for Hospital Quality Reporting (HQR)

The Centers for Medicare & Medicaid Services (CMS) has re-published the 2025 CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guide (IG) Hospital Quality Reporting (HQR). The 2025 CMS QRDA I IG outlines requirements for hospitals to report electronic clinical quality measures (eCQMs) for the calendar year 2025 reporting period for the Hospital Inpatient Quality Reporting (IQR) Program, the Medicare Promoting Interoperability Program, and the Outpatient Quality Reporting (OQR) Program.

The 2025 CMS QRDA I IG Version 1.1 contains these high-level changes:

• Removal of HQR validation rule CMS_0063.
• Addition of HQR validation rule CMS_0090, “The facility is closed within the HQR system and file submissions will not be accepted”
• Updated HQR validation rule CMS_0082 for new CMS EHR Certification ID format starts with “2025C” and updated CMS EHR Certification ID guidance
• Addition of HQR feedback message, “The submitted QRDA file did not produce outcomes for any of the specified measures”
• Added HQR validation rules for the effectiveTime element of Diagnostic Study Performed 

There were no changes to the 2025 CMS QRDA I Schematron File or sample files. 

Additional QRDA-Related Resources:

• To find out more about QRDA and eCQMs, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center QRDA and Getting Started with eCQMs pages.
• 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.