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2026 MIPS Measure #048: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Quality ID
048
High Priority Measure
No
Specifications
Registry
Measure Type
Process
Specialty
Family Medicine
Geriatrics
Internal Medicine
Obstetrics/Gynecology
Physical Therapy/Occupational Therapy
Preventive Medicine
Urology

Measure Description

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months.

 

Instructions

This measure is to be submitted a minimum of once per performance period for denominator eligible cases as defined in the denominator criteria. This measure is intended to reflect the quality of services provided for female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence. This measure is appropriate for use in the ambulatory setting only and is considered a general screening measure. There is no diagnosis associated with this measure. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

NOTE: This measure is appropriate for and applicable to the telehealth setting. Patient encounters conducted via telehealth using encounter code(s) found in the denominator encounter criteria are allowed for this measure.

Measure Submission Type:

Measure data may be submitted by individual MIPS eligible clinicians, groups, or third-party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third-party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third-party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

 

Denominator

All female patients aged 65 years and older with a visit during the measurement period.

Denominator Criteria (Eligible Cases):

All female patients aged ≥ 65 years on date of encounter

AND

Patient encounter during the performance period (CPT or HCPCS): 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 98016, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, G0402

AND NOT

DENOMINATOR EXCLUSION:

Patient use of hospice services any time during the measurement period: G9693

 

Numerator

Patients who were assessed for the presence or absence of urinary incontinence within 12 months

Definition:

Urinary Incontinence – Any involuntary leakage of urine.

Numerator Options:

Performance Met: Presence or absence of urinary incontinence assessed (1090F)

OR

Performance Not Met: Presence or absence of urinary incontinence not assessed, reason not otherwise specified (1090F with 8P)

 

Rationale

Female patients may not volunteer information regarding incontinence, so they should be asked by their physician.

 

Clinical Recommendation Statements

Strategies to increase recognition and reporting of urinary incontinence (UI) are required and especially the perception that it is an inevitable consequence of aging for which little or nothing can be done. (ICI)

Patients with urinary incontinence should undergo a basic evaluation that includes a history, physical examination, measurement of post-void residual volume, and urinalysis. (ACOG) (Level C)

Health care providers should be able to initiate evaluation and treatment of UI basing their judgment on the results of history, physical examination, post-voiding residual and urinalysis. (ICI) (Grade B for women)