Frequently Asked Questions Updated for 2023

2. What are the main differences from 2018’s Advancing Care Information (ACI) performance category, and 2022/2023’s PI performance category?

• In 2019, CMS tabled the ACI performance category and replaced it with the 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 the performance year, 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
  (1) Protect Patient Health Information	Security Risk Analysis	Required	0	Yes/No Statement	N/A
  	Safety Assurance Factors for EHR Resilience (SAFER) Guides	Required	0	Yes/No Statement	N/A
  (2) Electronic Prescribing	e-Prescribing	Required	10	Numerator / Denominator	Write fewer than 100 permissible prescriptions
  	Query of Prescription Drug Monitoring Program (PDMP)	Required	10	Yes/No Statement	Unable to electronically prescribe Schedule II opioids and Schedule III and IV drug in accordance with applicable law during the performance period Write fewer than 100 permissible prescriptions If querying a PDMP would impose an excessive worklfow or cost burden prior to the start of the performance period
  (3) Health Information Exchange	Support Electronic Referral Loops by Sending Health Information	Required	15	Numerator / Denominator	Transfer or refer patients fewer than 100 times
  	Support Electronic Referral Loops by Receiving and Reconciling Health Information	Required	15	Numerator / Denominator	Receive fewer than 100 transitions of care or referrals, or has fewer than 100 encounters with patients never encountered during performance year
  	Health Information Exchange Bi-Directional Exchange (required if submitted as an alternative to the two above)	Required	30	Yes/No Statement	N/A
  	Enabling Exchange under Trusted Exchange Framework and Common Agreement (TEFCA) (required if submitted as an alternative to the two above)	Required	30	Yes/No Statement	N/A
  (4) Provider to Patient Exchange	Provide Patients Electronic Access to their Health Information	Required	25	Numerator / Denominator	N/A
  (5) 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	Required	25	Yes/No Statement You will receive full points for submitting to 2 registries OR submitting to 1 registry and claiming 1	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

• There are 10 total measures associated with the 4 objectives previously named (aside from the mandatory Security Risk Analysis), which make up the PI performance score. In actuality, only certain measures must be reported to receive a PI score (one Public Health and Clinical Data Exchange measure is for bonus points). More information on measuring requirements can be found on PAI’s PI Category Overview.  
• 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.

---