2020 MIPS Measure #239: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Quality ID 239
eMeasure ID CMS155v8
High Priority Measure No
Specifications EHR
Measure Type Process
Specialty Nutrition/Dietician Pediatrics

Measure description

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


This measure is an electronic clinical quality measure (eCQM) that is expressed and formatted to use data from electronic health records (EHR) to measure healthcare quality.


Patients 3-17 years of age with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period

Denominator Exclusions:

  • Patients who have a diagnosis of pregnancy during the measurement period.
  • Exclude patients whose hospice care overlaps the measurement period.


Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period

Numerator 2: Patients who had counseling for nutrition during the measurement period

Numerator 3: Patients who had counseling for physical activity during the measurement period


Over the last three decades, childhood obesity has more than doubled in children and tripled in adolescents. Approximately 15 percent of children and adolescents in the United States are overweight and 17 percent are obese (Fryar, Carroll, & Ogden, 2014).

Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, stroke and several types of cancer (Centers for Disease Control and Prevention, 2013.

The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014).

Since obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).

Clinical Recommendation Statement

U.S. Preventive Services Task Force (2017):

  • The task force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)

American Academy of Pediatrics -Bright Futures (Hagan, Shaw, & Duncan, 2017):

  • Plot and assess BMI percentiles routinely for early recognition of overweight and obesity.
  • Assess barriers to healthy eating and physical activity.
  • Provide anticipatory guidance for nutrition and physical activity.

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