The 2026 MIPS quality measures CMS lists as relevant to Otolaryngology. Pick the highest-scoring set for your practice — our certified consultants can help.
Reporting MIPS for a Otolaryngology 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 Otolaryngology; open any for its full numerator, denominator, and exclusions.
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not…
The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic order on or within 3 days after the episode date and a group A Streptococcus (Strep) test in the seven-day period from three days prior…
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 65 years and older with a history of falls who had a plan of care for falls documented within 12 months. Instructions This measure is to be submitted a minimum of once per performance period for patients seen during the performance…
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 with a diagnosis of obstructive sleep apnea who had an apnea hypopnea index (AHI), a respiratory disturbance index (RDI), or a respiratory event index (REI) documented or measured within 2 months after initial evaluation for suspected obstructive…
Percentage of patients aged 18 years and older with a diagnosis of obstructive sleep apnea (OSA) that were prescribed an evidence-based therapy that had documentation that adherence to therapy was assessed at least annually through an objective informatics system or through self-reporting (if objective reporting…
Percentage of patient visits for patients aged 18 years and older seen during the performance period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive. Instructions This measure is to be…
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period Rationale As the leading cause of both fatal and nonfatal injuries for older adults, falls are one of the most common and significant health issues…
Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms. Instructions This measure may be submitted based on the actions of the submitting Merit-based Incentive Payment System (MIPS)…
Percentage of patients aged 18 years and older with a diagnosis of acute bacterial sinusitis that were prescribed amoxicillin, with or without clavulanate, as a first line antibiotic at the time of diagnosis. Instructions This measure may be submitted based on the actions of the…
Percentage of patients aged 18 years and older who had any unplanned reoperation within the 30-day postoperative period. Instructions This measure is to be submitted each time an operative procedure listed in the denominator is performed during the performance period. There is no diagnosis associated…
Percentage of patients aged 18 years and older who had a surgical site infection (SSI). Instructions This measure is to be submitted each time a denominator eligible procedure as defined in the denominator criteria is performed. Intent and Clinician Applicability: This measure is intended to…
Percentage of patients who underwent a non-emergency surgery who had their personalized risks of postoperative complications assessed by their surgical team prior to surgery using a clinical data-based, patient-specific risk calculator and who received personal discussion of those risks with the surgeon. Instructions This measure…
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…
Composite measure of the percentage of pediatric and adult patients whose asthma is well-controlled as demonstrated by one of three age appropriate patient reported outcome tools and not at risk for exacerbation. Instructions This measure is to be submitted a minimum of once per performance…
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 12 months AND who received brief counseling if identified as an unhealthy alcohol user. Instructions This measure is to…
Percentage of patients aged 2 months through 12 years with a diagnosis of OME who were not prescribed systemic antimicrobials. Instructions This measure is to be submitted once for each occurrence of otitis media with effusion (OME) in children seen during the performance period. Each…
Percentage of patients 19 years of age and older who are up-to-date on recommended routine vaccines for influenza; tetanus and diphtheria (Td) or tetanus, diphtheria and acellular pertussis (Tdap); zoster; pneumococcal; and hepatitis B. Instructions This measure is to be submitted a minimum of once…
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