2022 MIPS Quality Benchmarks

What Are Quality Measure Benchmarks?

When a clinician or group submits measures for the Merit-based Incentive Payment System (MIPS) quality performance category, each measure is assessed against its benchmark to determine how many points the measure earns. In program year 2020, a clinician or group can receive anywhere from 3 to 10 points* for each MIPS measure (not including any bonus points) that meets the data completeness standards and case minimum requirements through Benchmarks. Benchmarks are specific to the collection type: Qualified Clinical Data Registry (QCDR) measures, MIPS Clinical Quality Measures (MIPS CQMs)*, eCQMs, CMS Web Interface measures, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS survey, and Part B Claims measures. In order to measure performance that is comparable across the spectrum of performance, benchmarks are established using historical data. Historical benchmarks are based on actual performance data from 2018 that was submitted to the Quality Payment Program (QPP) in 2018.  *MIPS CQMs are measures submitted using registry rules.

How Do Benchmarks Work for Multi-Performance Rate Measures?

Several MIPS quality measures require the collection and submission of data for multiple populations. This means that there can be multiple performance rates associated with a single measure. Historical benchmarks for multi-performance rate measures are created based on an "overall performance rate" (based on a weighted average, simple average or CMS-specified performance rate):

How Are Benchmarks Displayed?

Each benchmark is presented in terms of deciles. Points will be awarded within each decile (see table below). Clinicians who receive a score in the first or second decile will receive 3 points. Clinicians who are in the 3rd decile will receive somewhere between 3 and 3.9 points depending on their exact position in the decile, and clinicians in higher deciles will receive a corresponding number of points. For example, if a clinician submits performance data of 83% on a non-inverse measure, and the 5th decile begins at 72% and the 6th decile begins at 85%, then the clinician will receive between 5 and 5.9 points because 83% is in the 5th decile. For inverse measures where a higher performance is seen by a lower number on the performance score, the scores are reversed in the benchmark deciles (example: Measure 1). An Excel version of the 2022 MIPS Quality Historical Benchmarks can be found here

*Measures marked in blue (example: Measure 130) can only earn a maximum score of 7 points.  There are 77 Measures that meet this description.  Topped-out means that the national median performance rate is so high that there is no meaningful difference in performance between clinicians.

Measure NameMeasure IDCollection TypeDecile 3Decile 4Decile 5Decile 6Decile 7Decile 8Decile 9Decile 10
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)001MIPS CQM79.99 - 70.0170.00 - 60.0160.00 - 50.0150.00 - 40.0140.00 - 30.0130.00 - 20.0120.00 - 10.01<= 10.00
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)001eCQM79.99 - 70.0170.00 - 60.0160.00 - 50.0150.00 - 40.0140.00 - 30.0130.00 - 20.0120.00 - 10.01<= 10.00
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)001Medicare Part B Claims79.99 - 70.0170.00 - 60.0160.00 - 50.0150.00 - 40.0140.00 - 30.0130.00 - 20.0120.00 - 10.01<= 10.00
Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)005MIPS CQM92.00 - 96.2996.30 - 98.2898.29 - 99.99--100------
Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)005eCQM70.26 - 75.7575.76 - 78.5678.57 - 81.8181.82 - 85.4685.47 - 88.8888.89 - 92.3092.31 - 95.38>= 95.39
Coronary Artery Disease (CAD): Antiplatelet Therapy006MIPS CQM77.78 - 83.0183.02 - 86.4886.49 - 89.3889.39 - 92.6592.66 - 96.1296.13 - 99.8399.84 - 99.99100
Coronary Artery Disease (CAD): Beta-Blocker Therapy – Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)007MIPS CQM80.76 - 86.8086.81 - 89.9990.00 - 91.8591.86 - 96.9196.92 - 99.99----100
Coronary Artery Disease (CAD): Beta-Blocker Therapy – Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)007eCQM82.14 - 84.7484.75 - 86.5886.59 - 88.4588.46 - 90.1790.18 - 91.7991.80 - 93.5893.59 - 95.99>= 96.00
Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)008MIPS CQM94.35 - 97.4997.50 - 99.0799.08 - 99.99--100------
Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)008eCQM85.00 - 87.8287.83 - 90.1290.13 - 91.2891.29 - 92.5892.59 - 94.2594.26 - 95.6495.65 - 97.30>= 97.31
Anti-Depressant Medication Management009eCQM65.42 - 74.1374.14 - 78.0678.07 - 80.7580.76 - 82.6082.61 - 84.8384.84 - 87.3987.40 - 91.06>= 91.07
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation012eCQM79.88 - 86.8286.83 - 91.4091.41 - 94.6394.64 - 96.6896.69 - 98.1498.15 - 99.1799.18 - 99.99100.00
Age-Related Macular Degeneration (AMD): Dilated Macular Examination014MIPS CQM87.99 - 92.4492.45 - 95.8195.82 - 97.8597.86 - 99.3399.34 - 100------
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care019MIPS CQM78.82 - 90.3690.37 - 96.6296.63 - 99.6799.68 - 99.99100------
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care019eCQM61.26 - 71.4271.43 - 78.9478.95 - 84.8184.82 - 89.4389.44 - 93.2893.29 - 96.5196.52 - 98.90>= 98.91
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older024MIPS CQM22.73 - 49.9950.00 - 66.8166.82 - 81.5281.53 - 89.3589.36 - 96.3596.36 - 99.99--100
Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older024Medicare Part B Claims----------------
Screening for Osteoporosis for Women Aged 65-85 Years of Age039MIPS CQM16.80 - 28.8828.89 - 44.2344.24 - 55.1755.18 - 64.5064.51 - 74.0174.02 - 82.6482.65 - 95.50>= 95.51
Screening for Osteoporosis for Women Aged 65-85 Years of Age039Medicare Part B Claims37.50 - 51.8451.85 - 62.0662.07 - 72.3372.34 - 79.9980.00 - 91.5391.54 - 97.7797.78 - 99.99100
Advance Care Plan047MIPS CQM28.58 - 52.1652.17 - 72.0572.06 - 85.2785.28 - 93.6693.67 - 98.3298.33 - 99.7599.76 - 99.99100
Advance Care Plan047Medicare Part B Claims75.63 - 97.8597.86 - 99.6299.63 - 99.99--100------
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older 048MIPS CQM11.59 - 27.5327.54 - 49.7849.79 - 66.8866.89 - 81.7581.76 - 94.0094.01 - 99.6799.68 - 99.99100
Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older050MIPS CQM50.60 - 71.6571.66 - 82.0982.10 - 90.8890.89 - 96.5996.60 - 99.99----100
Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy052MIPS CQM70.37 - 81.6581.66 - 94.1894.19 - 97.9497.95 - 99.8499.85 - 100------
Appropriate Treatment for Upper Respiratory Infection (URI)065MIPS CQM----------------
Appropriate Treatment for Upper Respiratory Infection (URI)065eCQM82.14 - 86.0586.06 - 88.6688.67 - 91.3191.32 - 93.5493.55 - 95.7995.80 - 98.0198.02 - 99.99100
Appropriate Testing for Pharyngitis066MIPS CQM84.44 - 88.8888.89 - 91.8391.84 - 93.9393.94 - 95.6495.65 - 97.3697.37 - 99.99--100
Appropriate Testing for Pharyngitis066eCQM55.26 - 67.6467.65 - 75.4475.45 - 80.9580.96 - 85.3885.39 - 88.2088.21 - 92.1992.20 - 95.87>= 95.88
Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections 076MIPS CQM95.60 - 98.9598.96 - 99.99----100------
Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections076Medicare Part B Claims--------100------
Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use093MIPS CQM86.21 - 91.1391.14 - 94.0194.02 - 96.1496.15 - 97.4997.50 - 100------
Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients102MIPS CQM----------------
Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients102eCQM----------------
Prostate Cancer: Combination Androgen Deprivation Therapy for High Risk or Very High Risk Prostate Cancer 104MIPS CQM83.62 - 94.2494.25 - 98.3098.31 - 99.99--100------
Adult Major Depressive Disorder (MDD): Suicide Risk Assessment107eCQM1.52 - 2.952.96 - 7.407.41 - 14.2814.29 - 25.8425.85 - 45.3045.31 - 67.7067.71 - 90.37>= 90.38
Preventive Care and Screening: Influenza Immunization110MIPS CQM34.52 - 49.4149.42 - 61.9061.91 - 73.3473.35 - 83.7383.74 - 92.5692.57 - 98.3698.37 - 99.99100
Preventive Care and Screening: Influenza Immunization110eCQM20.13 - 29.0329.04 - 36.8636.87 - 43.8343.84 - 50.6750.68 - 57.6557.66 - 65.9265.93 - 78.07>= 78.08
Preventive Care and Screening: Influenza Immunization110Medicare Part B Claims63.32 - 78.7378.74 - 86.9786.98 - 93.1893.19 - 98.3598.36 - 99.99----100
Pneumococcal Vaccination Status for Older Adults111MIPS CQM41.61 - 54.6754.68 - 63.5963.60 - 69.7669.77 - 74.5674.57 - 79.4479.45 - 85.7485.75 - 96.43>= 96.44
Pneumococcal Vaccination Status for Older Adults111eCQM22.14 - 36.4936.50 - 48.0848.09 - 57.6757.68 - 65.4365.44 - 72.8772.88 - 80.2380.24 - 88.35>= 88.36
Pneumococcal Vaccination Status for Older Adults111Medicare Part B Claims67.64 - 76.1576.16 - 81.8381.84 - 87.4987.50 - 93.3293.33 - 97.5997.60 - 99.99--100
Breast Cancer Screening112MIPS CQM23.06 - 39.4239.43 - 50.8450.85 - 60.5560.56 - 68.1068.11 - 74.8674.87 - 85.0685.07 - 98.24>= 98.25
Breast Cancer Screening112eCQM28.57 - 39.3839.39 - 48.5148.52 - 55.5555.56 - 61.4761.48 - 67.4367.44 - 73.5073.51 - 81.08>= 81.09
Breast Cancer Screening112Medicare Part B Claims66.67 - 76.1376.14 - 82.6682.67 - 87.0387.04 - 91.7191.72 - 96.1496.15 - 98.8598.86 - 99.99100
Colorectal Cancer Screening113MIPS CQM16.44 - 33.3733.38 - 50.4850.49 - 59.8359.84 - 72.0672.07 - 81.9381.94 - 92.3592.36 - 99.73>= 99.74
Colorectal Cancer Screening113eCQM20.83 - 33.3233.33 - 44.0344.04 - 52.8152.82 - 61.0361.04 - 69.0069.01 - 76.1776.18 - 84.33>= 84.34
Colorectal Cancer Screening113Medicare Part B Claims60.82 - 72.7272.73 - 82.7282.73 - 89.6589.66 - 95.5695.57 - 99.2799.28 - 99.99--100
Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis116MIPS CQM----------------
Diabetes: Eye Exam117MIPS CQM93.62 - 97.5697.57 - 99.2199.22 - 99.8199.82 - 99.99100------
Diabetes: Eye Exam117eCQM13.79 - 21.6921.70 - 30.0130.02 - 40.3340.34 - 54.5454.55 - 83.2083.21 - 98.3398.34 - 99.88>= 99.89
Diabetes: Eye Exam117Medicare Part B Claims--------------100
Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%)118MIPS CQM71.43 - 75.8575.86 - 78.4978.50 - 81.7881.79 - 84.5084.51 - 87.2687.27 - 91.9992.00 - 99.99100
Diabetes: Medical Attention for Nephropathy119MIPS CQM70.87 - 78.5178.52 - 84.4684.47 - 89.3489.35 - 93.8493.85 - 97.8297.83 - 99.99--100
Diabetes: Medical Attention for Nephropathy119eCQM73.58 - 78.5678.57 - 82.3682.37 - 85.2485.25 - 87.8587.86 - 90.7090.71 - 93.8793.88 - 98.35>= 98.36
Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy – Neurological Evaluation126MIPS CQM75.76 - 89.7789.78 - 96.4296.43 - 99.6699.67 - 99.99------100
Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of Footwear127MIPS CQM73.68 - 87.5187.52 - 98.0198.02 - 99.99--------100
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan128MIPS CQM37.57 - 61.0561.06 - 80.6880.69 - 91.8091.81 - 97.4897.49 - 99.5299.53 - 99.99--100
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan128eCQM23.95 - 29.0129.02 - 35.8335.84 - 44.9844.99 - 57.8157.82 - 73.4673.47 - 86.0786.08 - 95.31>= 95.32
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan128Medicare Part B Claims92.39 - 98.5198.52 - 99.7299.73 - 99.99--100------
Documentation of Current Medications in the Medical Record130MIPS CQM80.57 - 91.7591.76 - 96.3596.36 - 98.8098.81 - 99.8699.87 - 100------
Documentation of Current Medications in the Medical Record130eCQM80.60 - 88.4088.41 - 92.5192.52 - 95.3195.32 - 97.1597.16 - 100------
Documentation of Current Medications in the Medical Record130Medicare Part B Claims99.65 - 99.9699.97 - 99.99----100------
Preventive Care and Screening: Screening for Depression and Follow-Up Plan134MIPS CQM37.96 - 66.9566.96 - 84.5684.57 - 92.9092.91 - 98.1198.12 - 99.6899.69 - 99.99--100
Preventive Care and Screening: Screening for Depression and Follow-Up Plan134eCQM7.07 - 13.9313.94 - 22.4522.46 - 33.2133.22 - 45.2645.27 - 57.9958.00 - 71.7071.71 - 88.82>= 88.83
Preventive Care and Screening: Screening for Depression and Follow-Up Plan134Medicare Part B Claims96.55 - 99.6599.66 - 99.99----100------
Melanoma: Continuity of Care – Recall System137MIPS CQM98.15 - 99.99------------100
Melanoma: Coordination of Care138MIPS CQM81.28 - 96.0296.03 - 99.99----100------
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care141MIPS CQM46.51 - 68.6068.61 - 81.7781.78 - 90.3990.40 - 95.4195.42 - 98.3798.38 - 99.99--100
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care141Medicare Part B Claims--------------100
Oncology: Oncology: Medical and Radiation – Pain Intensity Quantified143MIPS CQM90.82 - 96.5996.60 - 98.7398.74 - 99.7499.75 - 99.99100------
Oncology: Medical and Radiation - Pain Intensity Quantified143eCQM76.92 - 87.4387.44 - 92.9993.00 - 96.0396.04 - 97.4897.49 - 100------
Oncology: Medical and Radiation – Plan of Care for Pain 144MIPS CQM64.63 - 79.5879.59 - 87.4987.50 - 93.5493.55 - 97.1297.13 - 99.1599.16 - 99.99--100
Radiology: Exposure Dose Indices or Exposure Time and Number of Images Reported for Procedures Using Fluoroscopy145MIPS CQM94.11 - 99.0899.09 - 99.9799.98 - 99.99--100------
Radiology: Exposure Dose Indices or Exposure Time and Number of Images Reported for Procedures Using Fluoroscopy145Medicare Part B Claims74.01 - 89.6389.64 - 95.7395.74 - 99.5899.59 - 99.99100------
Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy147MIPS CQM97.16 - 99.8499.85 - 99.99----100------
Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy147Medicare Part B Claims60.00 - 82.2182.22 - 95.2395.24 - 98.2398.24 - 99.99100------
Falls: Plan of Care155MIPS CQM94.30 - 98.6398.64 - 99.99----100------
Falls: Plan of Care155Medicare Part B Claims95.00 - 99.99------100------
Coronary Artery Bypass Graft (CABG): Prolonged Intubation164MIPS CQM11.69 - 10.0110.00 - 8.348.33 - 7.647.63 - 5.675.66 - 5.075.06 - 3.783.77 - 0.010.00
Coronary Artery Bypass Graft (CABG): Postoperative Renal Failure167MIPS CQM3.92 - 3.243.23 - 2.512.50 - 2.012.00 - 1.441.43 - 1.201.19 - 0.01--0.00
Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration168MIPS CQM4.00 - 3.473.46 - 2.712.70 - 2.062.05 - 1.651.64 - 1.291.28 - 0.01--0.00
Tuberculosis Screening Prior to First Course Biologic Therapy176MIPS CQM67.44 - 84.3784.38 - 94.9995.00 - 99.5299.53 - 99.99100------
Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity177MIPS CQM50.74 - 71.8971.90 - 79.6679.67 - 88.8088.81 - 94.5694.57 - 99.3999.40 - 99.99--100
Rheumatoid Arthritis (RA): Functional Status Assessment178MIPS CQM88.57 - 93.3293.33 - 97.8497.85 - 99.6899.69 - 99.99100------
Rheumatoid Arthritis (RA): Glucocorticoid Management180MIPS CQM--------100------
Elder Maltreatment Screen and Follow-Up Plan181MIPS CQM94.23 - 98.5698.57 - 99.7999.80 - 99.99--100------
Elder Maltreatment Screen and Follow-Up Plan181Medicare Part B Claims99.11 - 99.99------100------
Functional Outcome Assessment182MIPS CQM98.59 - 99.7199.72 - 99.9799.98 - 99.99--100------
Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of Inappropriate Use 185MIPS CQM81.40 - 89.3689.37 - 98.2798.28 - 99.5599.56 - 99.99100------
Stroke and Stroke Rehabilitation: Thrombolytic Therapy187MIPS CQM86.46 - 93.4193.42 - 96.1496.15 - 99.99--100------
Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery191MIPS CQM92.76 - 95.5195.52 - 97.3497.35 - 98.5498.55 - 99.99------100
Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery191eCQM88.70 - 92.9792.98 - 95.3095.31 - 96.8296.83 - 97.9297.93 - 98.8098.81 - 99.6399.64 - 99.99100
HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis205MIPS CQM----------------
Functional Status Change for Patients with Knee Impairments217MIPS CQM42.89 - 47.0747.08 - 49.9950.00 - 52.8452.85 - 60.9760.98 - 67.8567.86 - 75.8575.86 - 88.45>= 88.46
Functional Status Change for Patients with Hip Impairments218MIPS CQM40.43 - 42.6242.63 - 48.2748.28 - 50.6750.68 - 54.8954.90 - 58.9658.97 - 63.2163.22 - 72.40>= 72.41
Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments219MIPS CQM36.67 - 43.5143.52 - 48.3848.39 - 51.4751.48 - 53.9153.92 - 60.5260.53 - 66.3266.33 - 74.46>= 74.47
Functional Status Change for Patients with Low Back Impairments220MIPS CQM40.75 - 45.7845.79 - 48.9648.97 - 54.8954.90 - 62.1862.19 - 68.2868.29 - 74.0274.03 - 87.17>= 87.18
Functional Status Change for Patients with Shoulder Impairments221MIPS CQM35.59 - 40.2340.24 - 44.6344.64 - 50.9750.98 - 53.3253.33 - 61.8461.85 - 73.8473.85 - 81.43>= 81.44
Functional Status Change for Patients with Elbow, Wrist or Hand Impairments222MIPS CQM38.71 - 44.3544.36 - 49.9950.00 - 52.3552.36 - 58.6958.70 - 62.9562.96 - 72.0572.06 - 78.56>= 78.57
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention226MIPS CQM----------------
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention226eCQM----------------
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention226Medicare Part B Claims----------------
Controlling High Blood Pressure236MIPS CQM20.00 - 29.9930.00 - 39.9940.00 - 49.9950.00 - 59.9960.00 - 69.9970.00 - 79.9980.00 - 89.99>= 90.00
Controlling High Blood Pressure236eCQM51.76 - 56.8056.81 - 60.6660.67 - 64.1064.11 - 67.5167.52 - 71.1071.11 - 75.5375.54 - 81.42>= 80.43
Controlling High Blood Pressure236Medicare Part B Claims20.00 - 29.9930.00 - 39.9940.00 - 49.9950.00 - 59.9960.00 - 69.9970.00 - 79.9980.00 - 89.99>= 90.00
Use of High-Risk Medications in Older Adults238MIPS CQM----------------
Use of High-Risk Medications in Older Adults238eCQM----------------
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents239eCQM26.13 - 29.5329.54 - 31.6631.67 - 33.3233.33 - 35.5535.56 - 41.2241.23 - 50.4750.48 - 64.79>= 64.80
Childhood Immunization Status240eCQM23.53 - 31.6331.64 - 37.1337.14 - 41.2941.30 - 45.7345.74 - 49.9950.00 - 53.3553.36 - 59.90>= 59.91
Cardiac Rehabilitation Patient Referral from an Outpatient Setting 243MIPS CQM13.27 - 17.4717.48 - 23.7523.76 - 29.8629.87 - 36.4536.46 - 45.7545.76 - 59.0059.01 - 90.90>= 90.91
Barrett’s Esophagus249MIPS CQM--------100------
Barrett's Esophagus249Medicare Part B Claims--------100------
Radical Prostatectomy Pathology Reporting250MIPS CQM--------100------
Radical Prostatectomy Pathology Reporting250Medicare Part B Claims--------100------
Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal Pain254MIPS CQM90.55 - 93.4093.41 - 95.2395.24 - 96.6696.67 - 97.9998.00 - 100------
Rate of Open Repair of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post-Operative Day #7)258MIPS CQM----------------
Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post-Operative Day #2)259MIPS CQM----------------
Rate of Carotid Endarterectomy (CEA) for Asymptomatic Patients, without Major Complications (Discharged to Home by Post-Operative Day #2)260MIPS CQM----------------
Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness 261MIPS CQM----------------
Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness261Medicare Part B Claims----------------
Sentinel Lymph Node Biopsy for Invasive Breast Cancer264MIPS CQM----------------
Biopsy Follow-Up265MIPS CQM85.77 - 97.4497.45 - 99.99----100------
Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy268MIPS CQM5.26 - 15.3715.38 - 22.2122.22 - 46.2146.22 - 59.5459.55 - 74.9975.00 - 99.99--100
Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy275MIPS CQM----------------
Sleep Apnea: Severity Assessment at Initial Diagnosis277MIPS CQM24.14 - 40.3340.34 - 56.4656.47 - 77.7777.78 - 93.8793.88 - 99.99----100
Sleep Apnea: Assessment of Adherence to Positive Airway Pressure Therapy279MIPS CQM80.00 - 90.9090.91 - 96.5596.56 - 99.2899.29 - 99.8399.84 - 100------
Dementia: Cognitive Assessment281eCQM7.41 - 13.7213.73 - 21.9321.94 - 30.5030.51 - 41.4541.46 - 55.5355.54 - 71.4271.43 - 88.68>= 88.69
Dementia: Functional Status Assessment282MIPS CQM84.02 - 98.2798.28 - 99.99----100------
Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management 283MIPS CQM93.95 - 99.8599.86 - 99.99----100------
Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia286MIPS CQM94.56 - 99.8799.88 - 99.99----100------
Dementia: Education and Support of Caregivers for Patients with Dementia288MIPS CQM76.19 - 94.1094.11 - 99.6499.65 - 99.99--100------
Assessment of Mood Disorders and Psychosis for Patients with Parkinson’s Disease290MIPS CQM64.07 - 86.3586.36 - 94.4394.44 - 99.99--100------
Assessment of Cognitive Impairment or Dysfunction for Patients with Parkinson’s Disease291MIPS CQM40.25 - 75.5775.58 - 92.4992.50 - 99.99--100------
Rehabilitative Therapy Referral for Patients with Parkinson’s Disease293MIPS CQM16.16 - 43.3543.36 - 79.4379.44 - 82.6882.69 - 95.2395.24 - 99.99----100
Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery303MIPS CQM----------------
Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery304MIPS CQM----------------
Initiation and Engagement of Alcohol and Other Drug Dependence Treatment305eCQM0.78 - 1.071.08 - 1.371.38 - 1.661.67 - 2.072.08 - 2.892.90 - 4.404.41 - 7.68>= 7.69
Cervical Cancer Screening309eCQM12.33 - 18.8718.88 - 25.8025.81 - 32.8632.87 - 39.8539.86 - 47.1547.16 - 55.1155.12 - 68.73>= 68.74
Chlamydia Screening for Women310eCQM19.86 - 26.9126.92 - 31.5731.58 - 36.8636.87 - 41.6641.67 - 47.5847.59 - 54.3854.39 - 65.66>= 65.67
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented317MIPS CQM----------------
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented317eCQM----------------
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented317Medicare Part B Claims----------------
Falls: Screening for Future Fall Risk318eCQM13.88 - 27.9427.95 - 43.1943.20 - 58.3658.37 - 71.6671.67 - 83.1383.14 - 92.5892.59 - 98.05>= 98.06
Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients 320MIPS CQM87.10 - 92.4192.42 - 95.1295.13 - 96.9596.96 - 98.2798.28 - 100------
Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients320Medicare Part B Claims81.08 - 97.4397.44 - 99.99----100------
Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Preoperative Evaluation in Low-Risk Surgery Patients322MIPS CQM1.60 - 0.200.19 - 0.01----------0.00
Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention (PCI)323MIPS CQM0.05 - 0.01------------0.00
Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Testing in Asymptomatic, Low-Risk Patients324MIPS CQM3.91 - 0.550.54 - 0.01----------0.00
Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy 326MIPS CQM----------------
Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse) 331MIPS CQM70.27 - 55.6655.65 - 44.3144.30 - 32.8832.87 - 21.4421.43 - 11.8511.84 - 4.364.35 - 0.010.00
Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)332MIPS CQM69.39 - 73.8273.83 - 77.2677.27 - 82.0482.05 - 85.7085.71 - 90.4790.48 - 98.5698.57 - 99.99100
Maternity Care: Elective Delivery (Without Medical Indication) at < 39 Weeks (Overuse)335MIPS CQM----------------
Maternity Care: Postpartum Follow-Up and Care Coordination336MIPS CQM----------------
HIV Viral Load Suppression338MIPS CQM76.60 - 84.7184.72 - 88.0588.06 - 91.6491.65 - 93.7293.73 - 98.0398.04 - 99.99--100
HIV Medical Visit Frequency 340MIPS CQM50.57 - 58.0558.06 - 61.8961.90 - 70.6270.63 - 84.9284.93 - 88.6388.64 - 96.9196.92 - 99.99100
Rate of Carotid Artery Stenting (CAS) for Asymptomatic Patients, Without Major Complications (Discharged to Home by Post-Operative Day #2) 344MIPS CQM----------------
Total Knee or Hip Replacement: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy350MIPS CQM----------------
Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation351MIPS CQM----------------
Anastomotic Leak Intervention354MIPS CQM7.80 - 4.514.50 - 3.863.85 - 1.971.96 - 0.840.83 - 0.01----0.00
Unplanned Reoperation within the 30 Day Postoperative Period355MIPS CQM3.23 - 1.931.92 - 1.121.11 - 0.610.60 - 0.01------0.00
Unplanned Hospital Readmission within 30 Days of Principal Procedure356MIPS CQM5.95 - 4.184.17 - 2.812.80 - 2.172.16 - 1.071.06 - 0.01----0.00
Surgical Site Infection (SSI)357MIPS CQM2.56 - 1.051.04 - 0.400.39 - 0.01--------0.00
Patient-Centered Surgical Risk Assessment and Communication358MIPS CQM72.00 - 90.0690.07 - 97.2997.30 - 99.7499.75 - 99.99100------
Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose Radiation Imaging Studies: Computed Tomography (CT) and Cardiac Nuclear Medicine Studies 360MIPS CQM70.67 - 97.0397.04 - 99.7299.73 - 99.99--100------
Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT Imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines 364MIPS CQM61.39 - 78.9478.95 - 95.6495.65 - 99.99--100------
Follow-Up Care for Children Prescribed ADHD Medication (ADD)366eCQM----------------
Depression Remission at Twelve Months370MIPS CQM----------------
Depression Remission at Twelve Months370eCQM3.62 - 4.794.80 - 6.836.84 - 8.228.23 - 10.4110.42 - 13.5013.51 - 16.6616.67 - 23.90>= 23.91
Closing the Referral Loop: Receipt of Specialist Report374MIPS CQM63.18 - 84.3084.31 - 94.1194.12 - 98.5198.52 - 99.99100------
Closing the Referral Loop: Receipt of Specialist Report374eCQM7.59 - 12.2312.24 - 17.9217.93 - 24.9925.00 - 34.3434.35 - 47.8247.83 - 64.8564.86 - 86.12>= 86.13
Functional Status Assessment for Total Knee Replacement375eCQM2.65 - 4.624.63 - 6.616.62 - 8.888.89 - 10.9010.91 - 13.7813.79 - 20.7220.73 - 28.30>= 28.31
Functional Status Assessment for Total Hip Replacement376eCQM4.31 - 5.405.41 - 6.676.68 - 10.6110.62 - 12.7212.73 - 16.8616.87 - 20.9720.98 - 28.22>= 28.23
Functional Status Assessments for Heart Failure377eCQM----------------
Children Who Have Dental Decay or Cavities378eCQM0.87 - 0.370.36 - 0.01----------0.00
Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists379eCQM0.20 - 0.440.45 - 1.001.01 - 1.791.80 - 3.123.13 - 4.914.92 - 7.237.24 - 11.23>= 11.24
Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment382eCQM5.79 - 12.1912.20 - 18.4818.49 - 28.7628.77 - 36.8836.89 - 51.8951.90 - 64.5664.57 - 87.93>= 87.94
Adherence to Antipsychotic Medications For Individuals with Schizophrenia383MIPS CQM82.57 - 93.2593.26 - 95.9395.94 - 99.99--------100
Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating Room Within 90 Days of Surgery384MIPS CQM93.33 - 96.4296.43 - 97.9197.92 - 99.99--100------
Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement Within 90 Days of Surgery385MIPS CQM----------------
Amyotrophic Lateral Sclerosis (ALS) Patient Care Preferences386MIPS CQM----------------
Annual Hepatitis C Virus (HCV) Screening for Patients who are Active Injection Drug Users 387MIPS CQM----------------
Cataract Surgery: Difference Between Planned and Final Refraction 389MIPS CQM22.58 - 30.5030.51 - 40.4740.48 - 69.9369.94 - 92.8592.86 - 97.1997.20 - 99.8699.87 - 99.99100
Follow-Up After Hospitalization for Mental Illness (FUH)391MIPS CQM----------------
Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation Ablation392MIPS CQM----------------
Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation, Replacement, or Revision393MIPS CQM----------------
Immunizations for Adolescents394MIPS CQM6.45 - 8.108.11 - 12.4912.50 - 18.1818.19 - 21.7321.74 - 25.5625.57 - 33.3233.33 - 45.44>= 45.45
Lung Cancer Reporting (Biopsy/Cytology Specimens) 395MIPS CQM--------100------
Lung Cancer Reporting (Biopsy/Cytology Specimens)395Medicare Part B Claims--------100------
Lung Cancer Reporting (Resection Specimens)396MIPS CQM--------100------
Lung Cancer Reporting (Resection Specimens)396Medicare Part B Claims--------100------
Melanoma Reporting397MIPS CQM--------100------
Melanoma Reporting397Medicare Part B Claims99.26 - 99.99------100------
Optimal Asthma Control 398MIPS CQM35.71 - 44.1144.12 - 57.4957.50 - 79.2479.25 - 99.99------100
One-Time Screening for Hepatitis C Virus (HCV) for all Patients 400MIPS CQM----------------
Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis401MIPS CQM----------------
Tobacco Use and Help with Quitting Among Adolescents402MIPS CQM89.37 - 94.1294.13 - 96.8796.88 - 98.6698.67 - 99.7599.76 - 100------
Anesthesiology Smoking Abstinence404MIPS CQM53.76 - 63.0263.03 - 70.5870.59 - 76.5776.58 - 83.0283.03 - 88.9888.99 - 92.9092.91 - 99.59>= 99.60
Appropriate Follow-up Imaging for Incidental Abdominal Lesions405MIPS CQM75.71 - 88.7588.76 - 96.3496.35 - 98.5998.60 - 99.99100------
Appropriate Follow-up Imaging for Incidental Abdominal Lesions405Medicare Part B Claims----------------
Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients406MIPS CQM6.67 - 3.183.17 - 0.01----100------
406Medicare Part B Claims----------------
Clinical Outcome Post Endovascular Stroke Treatment409MIPS CQM----------------
Psoriasis: Clinical Response to Systemic Medications410MIPS CQM58.22 - 72.7272.73 - 84.6784.68 - 91.8891.89 - 96.6196.62 - 99.99----100
Door to Puncture Time for Endovascular Stroke Treatment413MIPS CQM----------------
Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older 415MIPS CQM82.27 - 86.7786.78 - 90.4790.48 - 94.6594.66 - 96.6196.62 - 98.1498.15 - 99.3299.33 - 99.99100
Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years416MIPS CQM25.00 - 17.8717.86 - 12.5112.50 - 9.209.19 - 5.575.56 - 2.012.00 - 0.01--0.00
Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years416Medicare Part B Claims----------------
Osteoporosis Management in Women Who Had a Fracture418MIPS CQM3.33 - 3.994.00 - 5.065.07 - 8.088.09 - 10.7010.71 - 15.1115.12 - 21.6121.62 - 54.54>= 54.55
Osteoporosis Management in Women Who Had a Fracture418Medicare Part B Claims----------------
Overuse of Imaging for the Evaluation of Primary Headache419MIPS CQM28.67 - 15.4915.48 - 9.539.52 - 5.515.50 - 4.434.42 - 2.952.94 - 1.541.53 - 0.010.00
Varicose Vein Treatment with Saphenous Ablation: Outcome Survey420MIPS CQM----------------
Appropriate Assessment of Retrievable Inferior Vena Cava (IVC) Filters for Removal421MIPS CQM----------------
Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse to Detect Lower Urinary Tract Injury422MIPS CQM----------------
Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse to Detect Lower Urinary Tract Injury422Medicare Part B Claims----------------
Perioperative Temperature Management424MIPS CQM98.40 - 99.5599.56 - 99.8899.89 - 99.9699.97 - 99.99100------
Photodocumentation of Cecal Intubation425MIPS CQM94.66 - 96.4996.50 - 97.8397.84 - 98.6498.65 - 99.1899.19 - 100------
Prevention of Post-Operative Nausea and Vomiting (PONV) – Combination Therapy430MIPS CQM98.38 - 99.3399.34 - 99.6799.68 - 99.8799.88 - 99.9899.99 - 100------
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling431MIPS CQM----------------
Proportion of Patients Sustaining a Bladder Injury at the Time of any Pelvic Organ Prolapse Repair432MIPS CQM----------------
Proportion of Patients Sustaining a Bowel Injury at the time of any Pelvic Organ Prolapse Repair433MIPS CQM----------------
Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques436MIPS CQM99.49 - 99.8899.89 - 99.9899.99 - 99.99--100------
Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques436Medicare Part B Claims96.31 - 98.6698.67 - 99.5499.55 - 99.9399.94 - 99.99100------
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease438MIPS CQM69.39 - 73.5273.53 - 78.9178.92 - 84.1584.16 - 89.1289.13 - 99.4999.50 - 99.99--100
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease438eCQM64.96 - 68.4168.42 - 70.6770.68 - 72.9172.92 - 75.1075.11 - 77.3877.39 - 80.0180.02 - 83.42>= 83.43
Age Appropriate Screening Colonoscopy 439MIPS CQM----------------
Skin Cancer: Biopsy Reporting Time – Pathologist to Clinician440MIPS CQM99.52 - 99.99------100------
Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control)441MIPS CQM28.24 - 39.0139.02 - 47.3747.38 - 59.4659.47 - 66.6666.67 - 72.2172.22 - 76.3476.35 - 80.60>= 80.61
Non-Recommended Cervical Cancer Screening in Adolescent Females443MIPS CQM----------------
Risk-Adjusted Operative Mortality for Coronary Artery Bypass Graft (CABG)445MIPS CQM3.85 - 3.293.28 - 2.642.63 - 2.182.17 - 1.701.69 - 1.281.27 - 0.01--0.00
Appropriate Workup Prior to Endometrial Ablation 448MIPS CQM----------------
Appropriate Treatment for Patients with Stage I (T1c) – III HER2 Positive Breast Cancer450MIPS CQM----------------
RAS (KRAS and NRAS) Gene Mutation Testing Performed for Patients with Metastatic Colorectal Cancer who receive Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibody Therapy451MIPS CQM----------------
Patients with Metastatic Colorectal Cancer and RAS (KRAS or NRAS) Gene Mutation Spared Treatment with Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibodies452MIPS CQM----------------
Percentage of Patients Who Died from Cancer Receiving Chemotherapy in the Last 14 Days of Life (lower score – better)453MIPS CQM17.86 - 15.9215.91 - 13.8013.79 - 11.4411.43 - 9.399.38 - 6.466.45 - 4.774.76 - 0.010.00
Percentage of Patients Who Died from Cancer Admitted to the Intensive Care Unit (ICU) in the Last 30 Days of Life (lower score – better)455MIPS CQM----------------
Percentage of Patients Who Died from Cancer Admitted to Hospice for Less than 3 days (lower score – better)457MIPS CQM14.81 - 11.2711.26 - 8.788.77 - 5.395.38 - 4.164.15 - 2.542.53 - 1.361.35 - 0.010.00
Back Pain After Lumbar Discectomy/Laminectomy459MIPS CQM----------------
Back Pain After Lumbar Fusion460MIPS CQM----------------
Leg Pain After Lumbar Discectomy/Laminectomy461MIPS CQM----------------
Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy462eCQM----------------
Prevention of Post-Operative Vomiting (POV) – Combination Therapy (Pediatrics)463MIPS CQM97.24 - 98.6998.70 - 99.7299.73 - 99.99--100------
Otitis Media with Effusion: Systemic Antimicrobials - Avoidance of Inappropriate Use464MIPS CQM86.79 - 90.9090.91 - 92.9192.92 - 95.5695.57 - 96.3996.40 - 100------
Uterine Artery Embolization Technique: Documentation of Angiographic Endpoints and Interrogation of Ovarian Arteries465MIPS CQM----------------
Continuity of Pharmacotherapy for Opioid Use Disorder (OUD)468MIPS CQM----------------
Functional Status After Lumbar Fusion469MIPS CQM----------------
Functional Status After Primary Total Knee Replacement470MIPS CQM----------------
Functional Status After Lumbar Discectomy/Laminectomy471MIPS CQM----------------
Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture472eCQM--------0.00------
Leg Pain After Lumbar Fusion473MIPS CQM----------------
HIV Screening475eCQM3.64 - 6.156.16 - 8.838.84 - 11.8411.85 - 14.9214.93 - 18.2118.22 - 22.7122.72 - 31.63>= 33.64
Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia476eCQM----------------
Multimodal Pain Management477MIPS CQM80.65 - 86.3986.40 - 93.1493.15 - 96.7096.71 - 98.6898.69 - 100------
Functional Status Change for Patients with Neck Impairments478MIPS CQM----------------
Intravesical Bacillus-Calmette Guerin for Non-muscle Invasive Bladder Cancer481eCQM----------------
Hemodialysis Vascular Access: Practitioner Level Long-term Catheter Rate482MIPS CQM----------------
Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM)483MIPS CQM----------------

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