2024 MIPS Measure #293: Rehabilitative Therapy Referral for Patients with Parkinson’s Disease

2024 COLLECTION TYPE:

MIPS Clinical Quality Measures (CQMS)

‌MEASURE TYPE: Process – High Priority

Description

‌Percentage of all patients with a diagnosis of Parkinson’s Disease (PD) who were referred to physical, occupational, speech, or recreational therapy once during the measurement period.

‌Instructions

This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of Parkinson’s disease 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.

NOTE: Patient encounters for this measure conducted via telehealth (including but not limited to encounters coded with GQ, GT, 95, POS 02, POS 10) are allowable.

‌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 patients with a diagnosis of Parkinson’s disease

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):

All patients regardless of age

AND

Diagnosis for Parkinson’s disease (ICD-10-CM): G20.A1, G20.A2, G20.B1, G20.B2, G20.C

AND

Patient encounter during the performance period (CPT): 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99242*, 99243*, 99244*, 99245*, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99421, 99422, 99423, 99441, 99442, 99443, 99483

Numerator

Patients who were referred to physical, occupational, speech, or recreational therapy once during the measurement period

Numerator Options:

Performance Met: Referral to physical, occupational, speech, or recreational therapy (G0042)

OR

Denominator Exception: Patient and/or care partner decline referral (G0041)

OR

Denominator Exception: Clinician determines patient does not require referral (G0038)

OR

Denominator Exception: Patient already receiving physical/occupational/speech/recreational therapy during the measurement period (G0040)

OR

Performance Not Met: Patient not referred, reason not otherwise specified (G0039)