MIPS Clinical Quality Measures (CQMS)
MEASURE TYPE: Patient Engagement / Experience – High Priority
Description
Percentage of patients aged 18 years and older who had cataract surgery and were satisfied with their care within 90 days following the cataract surgery, based on completion of the Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey.
Instructions
This measure is to be submitted each time a procedure for cataracts is performed during the performance period. This measure is intended to reflect the quality of services provided for the patient receiving cataract surgery.
Note: This is an outcome measure and will be calculated solely using Merit-based Incentive Payment System (MIPS) eligible clinician, group, or third-party intermediary submitted data.
-
For patients who receive the cataract surgical procedures specified in the denominator coding, it should be submitted whether or not the patient was satisfied with their care within 90 days following the cataract surgery.
-
Only procedures performed through September 30 of the performance period are eligible for the denominator. This will allow the post-operative period to occur before third-party intermediaries must submit data to CMS.
-
It is the responsibility of the third-party intermediary to collate and score the surveys.
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 aged 18 years and older who had cataract surgery
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
AND
Patient procedure during the performance period (CPT): 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984, 66987, 66988
WITHOUT
Modifier: 55 or 56
WITHOUT
Telehealth Modifier (including but not limited to): GQ, GT, 95, POS 02, POS 10
Numerator
Patients 18 years and older who were satisfied with their care within 90 days following cataract surgery, based on completion of the Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey
NUMERATOR NOTE: Denominator Exception(s) are determined within 90 days of the date of the denominator eligible procedure.
Numerator Options:
Performance Met: Satisfaction with care achieved within 90 days following cataract surgery (G0916)
OR
Denominator Exception: Patient care survey was not completed by patient (G0917)
OR
Performance Not Met: Satisfaction with care not achieved within 90 days following cataract surgery (G0918)
Stay updated with the latest news regarding MACRA and MIPS
The Healthmonix Advisor is a free news source that connects you to the latest in the value-based care industry!