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CMS Releases 2020 MIPS Quality Measure Benchmarks; Continues to Cap Measure Points for Several Ophthalmology Measures

This week, CMS released the Quality Measure Benchmarks for the 2020 performance year, which impacts 2022 payments. Measures are benchmarked based on historical performance on the measures and scored on a ten-point scale. Measures that have consistently high performance rates year to year may be considered “topped out” and have their scores capped at seven points, even if the clinician scores in the 8th or higher decile. ASCRS opposes CMS’ topped-out measure methodology and advocates that physicians should continue to receive full credit for maintaining high performance.

Capped measures that are outcome, high priority, or electronically submitted are still eligible for bonus points.

Capped measures for 2020 are:

Claims measures

  • 12, Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
  • 14, Age-Related Macular Degeneration (AMD): Dilated Macular Examination
  • 117, Diabetes: Eye Exam
  • 130, Documentation of Current Medications in the Medical Record

Registry Measures

  • 12, Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
  • 14, Age-Related Macular Degeneration (AMD): Dilated Macular Examination
  • 19, Diabetic Retinopathy: Communications with the Physician Managing Ongoing Diabetes Care
  • 117, Diabetes: Eye Exam
  • 130, Documentation of Current Medications in the Medical Record
  • 191, Cataracts: 20/40 or Better Visual Acuity with 90 Days Following Cataract Surgery
  • 402, Tobacco Use and Help with Quitting Among Adolescents

EHR Measures (reported when interfaced with IRIS Registry)

  • 130, Documentation of Current Medications in the Medical Record

Educational Resources