2026 #291 MIPS Measure Assessment of Cognitive Impairment or Dysfunction for Patients with Parkinson’s Disease

‌2026 COLLECTION TYPE:

MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS) CLINICAL QUALITY MEASURE (CQM)

‌MEASURE TYPE:

Process

‌DESCRIPTION:

Percentage of all patients with a diagnosis of Parkinson’s disease (PD) who were assessed for cognitive impairment or dysfunction once during the measurement period.

‌INSTRUCTIONS:

Reporting Frequency:

This measure is to be submitted a minimum of once per performance period for denominator eligible cases as defined in the denominator criteria.

‌Intent and Clinician Applicability:

This measure is intended to reflect the quality of services provided for patients with a diagnosis of Parkinson’s disease (PD). 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 Strata and Performance Rates:

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate.

‌Implementation Considerations:

For the purposes of MIPS implementation, this patient-process measure is submitted a minimum of once per patient during the performance period. The most advantageous quality data code will be used if the measure is submitted more than once.

‌Telehealth:

TELEHEALTH ELIGIBLE: This measure is appropriate for and applicable to the telehealth setting. Patient encounters conducted via telehealth using encounter code(s) found in the denominator encounter criteria are allowed for this measure. Therefore, if the patient meets all denominator criteria for a telehealth encounter, it would be appropriate to include them in the denominator eligible patient population. Telehealth eligibility is at the measure level for inclusion within the denominator eligible patient population and based on the measure specification definitions which are independent of changes to coding and/or billing practices.

‌Measure Submission:

The quality data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this collection type for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. The coding provided to identify the measure criteria: Denominator or Numerator, may be an example of coding that could be used to identify patients that meet the intent of this clinical topic. When implementing this measure, please refer to the ‘Reference Coding’ section to determine if other codes or code languages that meet the intent of the criteria may also be used within the medical record to identify and/or assess patients. 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): 90791, 90792, 90839, 96105, 96110*, 96112, 96116, 96125, 96130, 96132, 96156, 97129, 97165, 97166, 97167, 97168, 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99242*, 99243*, 99244*, 99245*, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99421, 99422, 99423, 99483

‌NUMERATOR:

Patients (or care partner as appropriate) who were assessed for cognitive impairment or dysfunction once during the measurement period.

Definition:

Assessed – Is defined as a discussion with the patient or care partner or use of a screening tool OR referral to neuropsychologist for testing.

Numerator Instructions:

Screening tools approved for use in this measure include:

• Dementia Rating Scale (DRS-2)
• Mini-Mental Status Examination (MMSE)
• Montreal Cognitive Assessment (MoCA)
• Neuro-QoL
• Parkinson’s Disease Dementia – Short Screen (PDD-SS)
• Parkinson Neuropsychiatric Dementia Assessment (PANDA)
• Parkinson’s Disease- Cognitive Rating Scale (PD-CRS)
• Patient-Reported Outcomes Measurement Information System (PROMIS)
• Scales for Outcomes of Parkinson’s Disease – Cognition (SCOPA- Cog)

Numerator Options:

Performance Met: Cognitive impairment or dysfunction assessed (3720F)

OR

Denominator Exception: Patient or care partner decline assessment (G0036) 

OR

Denominator Exception: On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available. (G0037)

OR

Performance Not Met: Cognitive impairment or dysfunction was not assessed, reason not otherwise specified (3720F with 8P)

RATIONALE:

Cognitive functioning impacts life satisfaction and health-related quality of life. It is anticipated that if assessed on an ongoing basis, cognitive deficits may be identified and addressed in a timely manner. Once identified, such deficits could be treated (or patients referred to appropriate resources) and thereby improve individuals quality of life.