2020 Topped Out MIPS Quality Measures: Claims Reporting

These measures are capped at 7 points for the 2020 performance period.

CMS defines a topped-out measure as one whose median performance score is 95% or higher and whose performance is “so high and unvarying that meaningful distinctions and improvement in performance can no longer be made.” CMS has established a 4-year timeline for identifying and removing topped-out measures. If a measure is classified as topped-out for 3 consecutive years, it may be removed the 4th year subject to rule-making and public comment period. In the final rule, CMS has added a new criterion for removing measures identified as “extremely topped-out,” that is, measures with an average performance within the 98th to 100th percentile. For these measures, regardless of where they are in the topped out measure lifecycle, CMS may propose to remove them in the following year’s rulemaking cycle. These measures may not follow the 4-year lifecycle that is applicable to other measures.