The PQRI bonus is 2% of total allowed Medicare charges for services paid under the Medicare Fee Schedule. This includes the 80% paid by Medicare and the 20% the practice collects from the patient or co-insurance.
The services included are E/M services, procedures, drug administration
Excluded services are the drugs themselves, labs, DME.
Patient charges that are eligible are those to fee-for-service Medicare patients, Railroad Retirement Medicare, and Medicare as a Secondary Payer, but not Medicare Advantage patients.
Also excluded: charges sent to Part A by Rural Health Centers, Federally Qualified Health Centers and the facility portion of provider based physician charges.