2019 MIPS Measure #444: Medication Management for People with Asthma

Measure Type High Priority Measure? Collection Type(s)
Process yes MIPS CQM

Measure Description

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

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This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of persistent asthma seen during the performance period. 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.

Measure Submission Type:

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.


Patients 5-64 years of age with persistent asthma and a visit during the measurement period

DENOMINATOR NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for MIPS CQMs.

Denominator Criteria (Eligible Cases):

Patients aged 5-64 years on date of encounter


Diagnosis for persistent asthma (ICD-10-CM): J45.30, J45.31, J45.32, J45.40, J45.41, J45.42, J45.50, J45.51, J45.52


Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381*, 99382*, 99383*, 99384*, 99385*, 99386*, 99387*, 99391*, 99392*, 99393*, 99394*, 99395*, 99396*, 99397*



Diagnosis of COPD, Emphysema, Obstructive Chronic Bronchitis, Chronic Respiratory Conditions Due to Fumes/Vapors, Cystic Fibrosis, or Acute Respiratory Failure any time during the patient’s history through the end of the measurement year: E84.0, E84.11, E84.19, E84.8, E84.9, J43.0, J43.1, J43.2, J43.8, J43.9, J44.0, J44.1, J44.9, J68.4, J96.00, J96.01, J96.02, J96.20, J96.21, J96.22, J98.2, J98.3


Any patients who had no asthma controller medications dispensed during the measurement year: G9808


Patients who use hospice services any time during the measurement period: G9809


The number of patients who achieved a proportion of days (PDC) of at least 75% for their asthma controller medications during the measurement year


PDC – The proportion of days covered by at least one asthma controller medication prescription, divided by the number of days in the treatment period. The treatment period is the period of time beginning on the earliest prescription dispensing date for any asthma controller medication during the measurement year through the last day of the measurement year.

Asthma Controller Medications

Description Prescriptions
Antiasthmatic combinations Dyphylline-guaifenesin


Antibody inhibitors Omalizumab
Inhaled steroid combinations Budesonide-formoterol




Inhaled corticosteroids Beclomethasone




Fluticasone CFC free Mometasone

Leukotriene modifiers Montelukast



Mast cell stabilizers Cromolyn
Methylxanthines Aminophylline



Anti-interleukin-5 Mepolizumab


Numerator Options:

Performance Met: Patient achieved a PDC of at least 75% for their asthma controller medication (G9810)


Performance Not Met: Patient did not achieve a PDC of at least 75% for their asthma controller medication (G9811)


Allergy/Immunology, CMS-Family-Medicine-2019, CMS-Internal-Medicine-2019, CMS-Pediatrics-2019, ENT/Otolaryngology, General Practice/Family Medicine, Internal Medicine, Pediatrics, Quality-2019