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MIPS Measures Relevant to Pediatrics

  1. Quality - 40% of total score:  Report 6 measures, including one Outcome or other High Priority measure for 12 months on at least 70% of eligible encounters to possibly earn more than 3 points on a measure. Note: Small practices (less than 16 in the practice) can earn 3 points on a measure if at least 1 eligible case is reported.  Suggestions for your specialty include, but are not limited to, the following:
    ID:
    065
    NQF:
    0069
    eMeasure ID:
    CMS154v9
    High Priority:
    Yes

    2021 MIPS Measure #065: Appropriate Treatment for Upper Respiratory Infection (URI)

    Percentage of episodes for patients 3 months of age and older with a diagnosis of upper respiratory infection (URI) that did not result in an antibiotic dispensing event

    Measure Type
    • Process
    Specifications
    Specialty
    • Family Medicine
    • Otolaryngology
    • Pediatrics
    • Urgent Care
    ID:
    066
    NQF:
    eMeasure ID:
    CMS146v9
    High Priority:
    Yes

    2021 MIPS Measure #066: Appropriate Testing for Pharyngitis

    The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic dispensing event and a group A streptococcus (strep) test

    Measure Type
    • Process
    Specifications
    Specialty
    • Emergency Medicine
    • Family Medicine
    • Pediatrics
    • Urgent Care
    ID:
    093
    NQF:
    0654
    eMeasure ID:
    High Priority:
    Yes

    2021 MIPS Measure #093: Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use

    Percentage of patients aged 2 years and older with a diagnosis of AOE who were not prescribed systemic antimicrobial therapy

    Measure Type
    • Process
    Specifications
    Specialty
    • Emergency Medicine
    • Family Medicine
    • Internal Medicine
    • Otolaryngology
    • Pediatrics
    • Urgent Care
    ID:
    110
    NQF:
    0041
    eMeasure ID:
    CMS147v10
    High Priority:
    No

    2021 MIPS Measure #110: Preventive Care and Screening: Influenza Immunization

    Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

    Measure Type
    • Process
    Specifications
    Specialty
    • Allergy/Immunology
    • Cardiology
    • Endocrinology
    • Family Medicine
    • Geriatrics
    • Infectious Disease
    • Internal Medicine
    • Nephrology
    • Obstetrics/Gynecology
    • Oncology
    • Otolaryngology
    • Pediatrics
    • Preventive Medicine
    • Pulmonology
    • Rheumatology
    • Skilled Nursing Facility
    ID:
    116
    NQF:
    0058
    eMeasure ID:
    High Priority:
    Yes

    2021 MIPS Measure #116: Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis

    The percentage of episodes for patients ages 3 months and older with a diagnosis of acute bronchitis/bronchiolitis that did not result in an antibiotic dispensing event.

    Measure Type
    • Process
    Specifications
    Specialty
    • Emergency Medicine
    • Family Medicine
    • Internal Medicine
    • Pediatrics
    • Preventive Medicine
    • Urgent Care
    ID:
    134
    NQF:
    0418
    eMeasure ID:
    CMS2v10
    High Priority:
    No

    2021 MIPS Measure #134: Preventive Care and Screening: Screening for Depression and Follow-Up Plan

    Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter

    Measure Type
    • Process
    Specifications
    Specialty
    • Audiology
    • Clinical Social Work
    • Endocrinology
    • Family Medicine
    • Internal Medicine
    • Mental/Behavioral Health
    • Neurology
    • Orthopedic Surgery
    • Pediatrics
    • Physical Therapy/Occupational Therapy
    • Preventive Medicine
    • Speech/Language Pathology
    ID:
    205
    NQF:
    0409
    eMeasure ID:
    High Priority:
    No

    2021 MIPS Measure #205: HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis

    Percentage of patients aged 13 years and older with a diagnosis of HIV/AIDS for whom chlamydia, gonorrhea, and syphilis screenings were performed at least once since the diagnosis of HIV infection

    Measure Type
    • Process
    Specifications
    Specialty
    • Infectious Disease
    • Pediatrics
    ID:
    239
    NQF:
    eMeasure ID:
    CMS155v9
    High Priority:
    No

    2021 MIPS Measure #239: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

    Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

    - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
    - Percentage of patients with counseling for nutrition
    - Percentage of patients with counseling for physical activity

    Measure Type
    • Process
    Specifications
    Specialty
    • Nutrition/Dietician
    • Pediatrics
    ID:
    240
    NQF:
    eMeasure ID:
    CMS117v9
    High Priority:
    No

    2021 MIPS Measure #240: Childhood Immunization Status

    Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three or four H influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday.

    Measure Type
    • Process
    Specifications
    Specialty
    • Pediatrics
    ID:
    305
    NQF:
    eMeasure ID:
    CMS137v9
    High Priority:
    Yes

    2021 MIPS Measure #305: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

    Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. Two rates are reported.

    a. Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis
    b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.

    Measure Type
    • Process
    Specifications
    Specialty
    • Family Medicine
    • Internal Medicine
    • Pediatrics
    ID:
    310
    NQF:
    eMeasure ID:
    CMS153v9
    High Priority:
    No

    2021 MIPS Measure #310: Chlamydia Screening for Women

    Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period

    Measure Type
    • Process
    Specifications
    Specialty
    • Obstetrics/Gynecology
    • Pediatrics
    ID:
    366
    NQF:
    eMeasure ID:
    CMS136v10
    High Priority:
    No

    2021 MIPS Measure #366: Follow-Up Care for Children Prescribed ADHD Medication (ADD)

    Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.

    a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
    b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.

    Measure Type
    • Process
    Specifications
    Specialty
    • Mental/Behavioral Health
    • Pediatrics
    ID:
    370
    NQF:
    0710
    eMeasure ID:
    CMS159v9
    High Priority:
    Yes

    2021 MIPS Measure #370: Depression Remission at Twelve Months

    The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event date

    Measure Type
    • Outcome
    Specifications
    Specialty
    • Clinical Social Work
    • Family Medicine
    • Geriatrics
    • Internal Medicine
    • Mental/Behavioral Health
    • Pediatrics
    ID:
    379
    NQF:
    eMeasure ID:
    CMS74v10
    High Priority:
    No

    2021 MIPS Measure #379: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists

    Percentage of children, age 0-20 years, who received a fluoride varnish application during the measurement period

    Measure Type
    • Process
    Specifications
    Specialty
    • Dentistry
    • Pediatrics
    ID:
    382
    NQF:
    1365e
    eMeasure ID:
    CMS177v9
    High Priority:
    Yes

    2021 MIPS Measure #382: Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment

    Percentage of patient visits for those patients aged 6 through 17 years with a diagnosis of major depressive disorder with an assessment for suicide risk

    Measure Type
    • Process
    Specifications
    Specialty
    • Clinical Social Work
    • Mental/Behavioral Health
    • Pediatrics
    ID:
    391
    NQF:
    0576
    eMeasure ID:
    High Priority:
    Yes

    2021 MIPS Measure #391: Follow-Up After Hospitalization for Mental Illness (FUH)

    The percentage of discharges for patients 6 years of age and older who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health practitioner. Two rates are submitted:

    • The percentage of discharges for which the patient received follow-up within 30 days after discharge
    • The percentage of discharges for which the patient received follow-up within 7 days after discharge
    Measure Type
    • Process
    Specifications
    Specialty
    • Internal Medicine
    • Mental/Behavioral Health
    • Pediatrics
    ID:
    394
    NQF:
    1407
    eMeasure ID:
    High Priority:
    No

    2021 MIPS Measure #394: Immunizations for Adolescents

    The percentage of adolescents 13 years of age who had one dose of meningococcal vaccine (serogroups A, C, W, Y), one tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccine, and have completed the human papillomavirus (HPV) vaccine series by their 13th birthday.

    Measure Type
    • Process
    Specifications
    Specialty
    • Family Medicine
    • Pediatrics
    ID:
    398
    NQF:
    eMeasure ID:
    High Priority:
    Yes

    2021 MIPS Measure #398: Optimal Asthma Control

    Composite measure of the percentage of pediatric and adult patients whose asthma is well-controlled as demonstrated by one of three age appropriate patient reported outcome tools and not at risk for exacerbation

    Measure Type
    • Outcome
    Specifications
    Specialty
    • Allergy/Immunology
    • Family Medicine
    • Internal Medicine
    • Otolaryngology
    • Pediatrics
    • Pulmonology
    ID:
    402
    NQF:
    2803
    eMeasure ID:
    High Priority:
    No

    2021 MIPS Measure #402: Tobacco Use and Help with Quitting Among Adolescents

    The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user

    Measure Type
    • Process
    Specifications
    Specialty
    • Allergy/Immunology
    • Cardiology
    • Clinical Social Work
    • Dermatology
    • Family Medicine
    • Gastroenterology
    • General Surgery
    • Internal Medicine
    • Mental/Behavioral Health
    • Neurology
    • Obstetrics/Gynecology
    • Oncology
    • Orthopedic Surgery
    • Otolaryngology
    • Pediatrics
    • Physical Medicine
    • Preventive Medicine
    • Rheumatology
    • Thoracic Surgery
    • Urgent Care
    • Vascular Surgery
    ID:
    444
    NQF:
    1799
    eMeasure ID:
    High Priority:
    Yes

    2021 MIPS Measure #444: Medication Management for People with Asthma

    The percentage of patients 5-64 years of age during the performance period who were identified as having persistent asthma and were dispensed appropriate medications that they remained on for at least 75% of their treatment period

    Measure Type
    • Process
    Specifications
    Specialty
    • Allergy/Immunology
    • Family Medicine
    • Internal Medicine
    • Pediatrics
    • Pulmonology
    ID:
    464
    NQF:
    0657
    eMeasure ID:
    High Priority:
    Yes

    2021 MIPS Measure #464: Otitis Media with Effusion: Systemic Antimicrobials - Avoidance of Inappropriate Use

    Percentage of patients aged 2 months through 12 years with a diagnosis of OME who were not prescribed systemic antimicrobials

    Measure Type
    • Process
    Specifications
    Specialty
    • Family Medicine
    • Otolaryngology
    • Pediatrics
    • Urgent Care
  2. PI: Promoting Interoperability - 25% of total score: For a minimum of 90 days, report all required measures. EHR technology certified to the 2015 Edition certification must be in place by October 3, 2021. There are exclusions available for most of the required measures. Please check your QPP Participation Status to see if you are automatically exempt from PI. If you are exempt, the 25% will be re-weighted to the Quality performance category making it 65% of your score.
  3. IA: Improvement Activities - 15% of total score:  Attest that you completed up to 2 high-weighted activities or 4 medium-weighted activities for a minimum of 90 days. Groups with 15 or fewer participants or if you are in a rural or health professional shortage area,  attest that you completed 1 high-weighted or 2 medium-weighted activities for a minimum of 90 days. A group can attest to an activity when at least 50% of the clinicians in the group perform the same activity during any continuous 90-day period (or as specified in the activity description) in the same performance year. There are over 100 possible activities to choose from. The following are suggestions only:

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