Physicians Advocacy Institute

Frequently Asked Questions Updated for 2019


2. What are the main differences from 2018’s ACI performance category and 2019’s new PI performance category?

  • Starting In 2019, CMS will table the Advancing Care Information (ACI) performance category and replace it with the Promoting Interoperability (PI) performance category.

    Unlike the ACI category in 2018, the PI performance category does not require a base score measure. Instead, to earn points in the PI category clinicians must collect data, for a minimum of any continuous 90-day period in 2019, on 4 major objectives: 1) e-Prescribing, 2) Health Information Exchange, 3) Provider to Patient Exchange, and 4) Public Health and Clinical Data Exchange. Furthermore, the measures associated with these objectives must be reported through CEHRT of 2015 Edition functionality. A description of these objectives and the measures associated with them can be found in the table below:
    PI Objectives and Measures
    Objective Measure Required for PI Score? Max Points Reporting Requirement Exclusion
    Electronic Prescribing E-Prescribing Required 10 Numerator / Denominator Write fewer than 100 permissible prescriptions
    Query of Prescription
    Drug Monitoring
    Program (PDMP)
    Bonus 5 Numerator / Denominator N/A
    Verify Opioid
    Treatment Agreemnt
    Bonus 5 Numerator / Denominator N/A
    Health Information Exchange Support Electronic Referral Loops by Receiving and Incorporating Health Information Required 20 Numerator / Denominator Transfer or refer patients fewer than 100 times
    Support Electronic Referral Loops by Sending Health Information Required 20 Numerator / Denominator
    • EC who is unable to implement measure for 2019
    • Receive fewer than 100 transitions of care or referrals, or has fewer than 100 encounters with patients never before encountered during performance year
    Provider to Patient Exchange Provide Patients Electronic Access to Their Health Information Required 40 Numerator / Denominator N/A
    Public Health and Clinical Data Exchange Report to two different public health agencies or clinical data registries for any of the following:
    • Immunization Registry Reporting
    • Electronic Case Reporting
    • Public Health Registry Reporting
    • Clinical Data Registry Reporting
    • Syndromic Surveillance Reporting
    Required 10 Yes/No
    Each of these measures has their own exclusion, but general exclusion criteria include:
    • Don't diagnose/treat any disease/condition associated with applicable registry/agency in their jurisdiction
    • Operate in a jurisdiction in which no agency/registry can accept electronic registry transactions in CEHRT-specified standards
    • Operate in a jurisdiction where no agency/registry has declared readiness to receive electronic registry transactions as of 6 months prior to start of performance period
    There are 11 total measures associated with the 4 objectives previously named, which make up the PI performance score. In actuality, only 6 out of the 11 must be reported to receive a PI score (two e-Prescribing measures are for bonus points, and you are only required to report 2 out of the 5 Public Health and Clinical Data Exchange measures).
    In certain circumstances you may claim an exclusion from measures under specific objectives. In this case, the scoring criteria will be reweighted, and the remaining measures you submit will have a larger impact on your overall PI performance score. See PAI’s PI Category Overview  for additional details

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