CMS Measure ID: #293
Collection Type: CQM
Reporting Frequency: Once per patient per year
High Priority: Yes
NQS Domain: Communication and Care Coordination
Measure Age: > 2 years
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 (e.g., encounters coded with GQ, GT, 95, or POS 02 modifiers) are allowable.
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 for registry submissions; however, these codes may be submitted for those registries that utilize claims data.
Percentage of all patients with a diagnosis of Parkinson’s Disease who were referred to physical, occupational, speech, or recreational therapy once during the measurement period.
2023 Benchmarks (from 2021 CMS data)
Topped out: No
Capped at 7: No
Decile 0: 0 – 0.78
Decile 1: 0.79 – 17.32
Minimum: 17.33 – 36.83
Decile 3: 36.84 – 68.96
Decile 4: 68.97 – 86.35
Decile 5: 86.36 – 92.95
Decile 6: 92.96 – 98.54
Decile 7: 98.55 – 99.99
Decile 10: 100 – 100
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
Diagnosis for Parkinson’s disease (ICD-10-CM): G20
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
Patients who were referred to physical, occupational, speech, or recreational therapy once during the measurement period
Referral to physical, occupational, speech, or recreational therapy (G0042)
Patient and/or care partner decline referral (G0041)
Clinician determines patient does not require referral (G0038)
Patient already receiving physical/occupational/speech/recreational therapy during the measurement period (G0040)
Performance Not Met:
Patient not referred, reason not otherwise specified (G0039)