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2023 # MBHR03 Pain Interference Response utilizing PROMIS


Measure Title: Pain Interference Response utilizing PROMIS

Description: The percentage of adult patients (18 years of age or older) who report chronic pain issues and demonstrated a response to treatment at one month from the index score.

To see additional details, please view the workflow diagram for this measure: View diagram

This measure relies on the PROMIS Pain Interference assessment tool, which can be found here.


Adult patients (18 years of age or older) who report chronic pain issues (i.e., persistent pain for at least 90 days) as significantly impacting their life

Denominator Criteria (Eligible cases):
Patients ages >= 18
Patients report chronic pain (i.e., persistent pain for at least 90 days)


Patient Encounter CPT codes: 0362T, 0373T, 90785, 90791, 90792, 90832,90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90875, 90876, 96110, 96112, 96113, 96116, 96121, 96127, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, 96156, 96158, 96159, 96164, 96165, 96167, 96170, 96171, 96178, 97129, 97130, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 98966, 98967, 98968, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,99354,  99355, 99406, 99407, 99408, 99409, 99446, 99447, 99448, 99449, 99484, 99492, 99493, 99494, G2011, G2061, G2062, G2063, G0396, G0397, G0402, G0438, G0439 

Patient self-reported pain impacting their life identified by a PROMIS Pain Interference short form of at least 4 items or computer adaptive test score > 60 (using T-score metric)

Numerator: The number of patients in the denominator who demonstrated a response to treatment via a PROMIS Pain Interference score that is reduced by 2 or more points from the index score, one month (+/- 21 days) after the index visit.

Denominator Exclusions: 

  • Patients who die OR
    • Are enrolled in hospice in the measurement year OR
    • Are unable to complete the PROMIS Pain Interference measure at follow-up due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, AND a suitable recorder (e.g., advocate) is not available

Denominator Exceptions: 

  • Patient refused to complete a PROMIS Pain Interference measure at follow-up OR
  • Ongoing care not indicated (e.g., referred to another provider or facility, consultation only) OR
  • Patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) OR
  • Medical reasons (e.g., scheduled for surgery or hospitalized)

National Quality Forum (NQF) number, if applicable

Care setting(s) 
Ambulatory Care: Clinician Office/Clinic; Ambulatory Care: Hospital; Home Care; Hospital; Hospital Inpatient; Hospital Outpatient; Long Term Care; Nursing Home; Outpatient Services; Rehabilitation Facility; Rehabilitation Facility: Inpatient

Telehealth, if applicable

Number of performance rates required for measures

Traditional vs. inverse measure

Proportional, continuous variable, and/or ratio measure indicator

Risk adjustment, if applicable

Submission pathway 
Traditional MIPS

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