The 2026 MIPS quality measures CMS lists as relevant to Ophthalmology. Pick the highest-scoring set for your practice — our certified consultants can help.
Reporting MIPS for a Ophthalmology practice means choosing 6 quality measures — including at least one Outcome or other High Priority measure — and reporting each on as many eligible cases as possible to be scored against CMS's national benchmarks. The measures below are the ones CMS lists as relevant to Ophthalmology; open any for its full numerator, denominator, and exclusions.
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more visits within 12 months Rationale Glaucoma is a group of diseases that damage the eye’s optic nerve and…
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the…
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of…
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. Instructions This measure is to be submitted at…
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) whose glaucoma treatment has not failed (the most recent IOP was reduced by at least 20% from the pre-intervention level) OR if the most recent IOP was not reduced…
Percentage of cataract surgeries for patients aged 18 years and older with a diagnosis of uncomplicated cataract and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye…
Percentage of patients aged 12 years and older who were screened for tobacco use one or more times within the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as…
Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Instructions This measure is to be submitted a minimum of once per performance period for patients seen during the performance period. There is…
Percentage of patients aged 18 years and older who had cataract surgery and had improvement in visual function achieved within 90 days following the cataract surgery, based on completing a pre-operative and post-operative visual function survey. Instructions This measure is to be submitted each time…
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…
Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred. Instructions This measure is to be submitted a minimum of once per performance period for denominator eligible cases as defined…
Patients aged 18 years and older who had surgery for primary rhegmatogenous retinal detachment who did not require a return to the operating room within 90 days of surgery. Instructions This measure is to be submitted each time a procedure for primary rhegmatogenous retinal detachment…
Patients aged 18 years and older who had surgery for primary rhegmatogenous retinal detachment and achieved an improvement in their visual acuity, from their preoperative level, within 90 days of surgery in the operative eye. Instructions This measure is to be submitted each time a…
Percentage of patients aged 18 years and older who had cataract surgery performed and who achieved a final refraction within +/- 1.0 diopters of their planned (target) refraction. Instructions This measure is to be submitted each time for denominator eligible cases as defined in the…
Percentage of patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservativefree triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant) who, within seven (7) weeks following the date of injection, are screened for elevated intraocular pressure (IOP) with tonometry with documented IOP…
Percentage of patients with a diagnosis of acute posterior vitreous detachment (PVD) in either eye who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks. Instructions This measure is to be submitted once for once per performance period for…
Percentage of patients with a diagnosis of acute posterior vitreous detachment (PVD) and acute vitreous hemorrhage in either eye who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks. Instructions This measure is to be submitted once per performance…
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