Year:  2017 2018 2019 2020 2021 2022 2023 2024 2025 

QPP Measure Sets

Internal Medicine

Includes the following individual measures:
#Measure TitleSubmission Methods
001Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)Claims, Electronic Health Record, Cms Web Interface, Registry
005Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)Electronic Health Record, Registry
006Coronary Artery Disease (CAD): Antiplatelet TherapyRegistry
007Coronary Artery Disease (CAD): Beta-Blocker Therapy – Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF ≤ 40%)Electronic Health Record, Registry
008Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)Electronic Health Record, Registry
009Anti-Depressant Medication ManagementElectronic Health Record
024Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and OlderClaims, Registry
039Screening for Osteoporosis for Women Aged 65-85 Years of AgeClaims, Registry
047Advance Care PlanClaims, Registry
048Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and OlderRegistry
050Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and OlderRegistry
116Avoidance of Antibiotic Treatment for Acute Bronchitis/BronchiolitisRegistry
117Diabetes: Eye ExamRegistry, Electronic Health Record
126Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological EvaluationRegistry
130Documentation of Current Medications in the Medical RecordRegistry, Electronic Health Record
134Preventive Care and Screening: Screening for Depression and Follow-Up PlanClaims, Electronic Health Record, Cms Web Interface, Registry
155Falls: Plan of CareClaims, Registry
176Tuberculosis Screening Prior to First Course of Biologic and/or Immune Response Modifier TherapyRegistry
181Elder Maltreatment Screen and Follow-Up PlanClaims, Registry
236Controlling High Blood PressureClaims, Electronic Health Record, Cms Web Interface, Registry
238Use of High-Risk Medications in Older AdultsElectronic Health Record, Registry
243Cardiac Rehabilitation Patient Referral from an Outpatient SettingRegistry
277Sleep Apnea: Severity Assessment at Initial DiagnosisRegistry
279Sleep Apnea: Assessment of Adherence to Obstructive Sleep Apnea (OSA) Therapy.Registry
305Initiation and Engagement of Substance Use Disorder TreatmentElectronic Health Record
309Cervical Cancer ScreeningElectronic Health Record
318Falls: Screening for Future Fall RiskElectronic Health Record, Cms Web Interface
321CAHPS for MIPS Clinician/Group SurveyCertified Survey Vendor
326Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation TherapyRegistry
331Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)Registry
332Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)Registry
338HIV Viral SuppressionElectronic Health Record, Registry
370Depression Remission at Twelve MonthsElectronic Health Record, Cms Web Interface, Registry
374Closing the Referral Loop: Receipt of Specialist ReportElectronic Health Record, Registry
377Functional Status Assessments for Heart FailureElectronic Health Record
383Adherence to Antipsychotic Medications For Individuals with SchizophreniaRegistry
387Annual Hepatitis C Virus (HCV) Screening for Patients who are Active Injection Drug UsersRegistry
398Optimal Asthma ControlRegistry
400One-Time Screening for Hepatitis C Virus (HCV) and Treatment InitiationRegistry
401Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with CirrhosisRegistry
418Osteoporosis Management in Women Who Had a FractureClaims, Registry
431Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief CounselingRegistry
438Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseElectronic Health Record, Cms Web Interface, Registry
441Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control)Registry
443Non-Recommended Cervical Cancer Screening in Adolescent FemalesRegistry
468Continuity of Pharmacotherapy for Opioid Use Disorder (OUD)Registry
472Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic FractureElectronic Health Record
475HIV ScreeningElectronic Health Record
476Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic HyperplasiaElectronic Health Record
483Person-Centered Primary Care Measure Patient Reported Outcome Performance Measure (PCPCM PRO-PM)Registry
487Screening for Social Drivers of HealthRegistry
488Kidney Health EvaluationRegistry, Electronic Health Record
493Adult Immunization StatusRegistry
495Ambulatory Palliative Care Patients’ Experience of Feeling Heard and UnderstoodRegistry
497Preventive Care and Wellness (composite)Registry
498Connection to Community Service ProviderRegistry
502Improvement or Maintenance of Functioning for Individuals with a Mental and/or Substance Use DisorderRegistry
503Gains in Patient Activation Measure (PAM) Scores at 12 MonthsRegistry
504Initiation, Review, And/Or Update To Suicide Safety Plan For Individuals With Suicidal Thoughts, Behavior, Or Suicide RiskRegistry
001SSPDiabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)Registry
134SSPPreventive Care and Screening: Screening for Depression and Follow-Up PlanRegistry
236SSPControlling High Blood PressureRegistry
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