Frequently Asked Questions

Cross-cutting measures are any measures that are broadly applicable across multiple clinical settings and eligible professionals (EPs) or group practices within a variety of specialties. The requirement of reporting cross-cutting measures was introduced to the Physician Quality Reporting System PQRS) program beginning in 2015 and remains a requirement for 2016 PQRS.

The requirement of reporting a cross-cutting measure is triggered if an EP or a group practice bills a face-to-face encounter. The Centers for Medicare & Medicaid Services (CMS) defines a face-to-face encounter as an instance in which the EP or group practice billed for services that are associated with face-to-face encounters under the Physician Fee Schedule (PFS). This includes general office visits, outpatient visits, and surgical procedure codes; however, CMS does not consider telehealth visits as a face-to-face encounter.

If an EP or group practice bills a service defined as a face-to-face encounter, CMS will analyze claims-based data to determine if a cross-cutting measure may have been applicable. If at least 15 cross-cutting measure denominator eligible encounters are found for an EP or group practice, then CMS maintains that the cross-cutting measure was applicable for that EP to report. If less than 15 cross-cutting measure denominator eligible encounters occur, then the cross-cutting measure requirement would not be applicable.

For more information on cross-cutting measures and face-to-face encounters navigate to the topics on the CMS.gov PQRS Measures Codes web page at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html and scroll down to view and click the hyperlinks for cross-cutting measures and/or face-to-face encounters.

The claims- and registry-based Measure-Applicability Validation (MAV) materials contain more information about this topic and can be located for the specific PQRS program year on the PQRS Web site on the Analysis and Payment web page found at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/AnalysisAndPayment.html

Please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or via e-mail at qnetsupport@hcqis.org should you have questions regarding this topic.

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