2022 MIPS Quality Measure Changes | Linden Healthcare Consulting

Every new MIPS year brings changes to the list of available quality measures. Below is a list of all MIPS quality measures that were added, deleted, or changed for the 2022 performance year in the Final Rule. Click the link in the measure title to see the final rule description for new or changed measures (tip: skip to the section titled “Rationale” for a summary of the measure changes and why they are being made).

New Quality Measures – Also new for 2022 scoring, these measures will have a 7-point minimum score in their first year (2022) and a 5-point minimum in the second year (2023).

Removed Quality Measures – These measures will no longer be available to report by the mechanism(s) listed.

Six measures were removed as a claims-based measures, but retained as MIPS CQMs:
- #14: Age-Related Macular Degeneration (AMD): Dilated Macular Examination
- #50: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older
- #93: Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use
- #182: Functional Outcome Assessment – measure changes also finalized for MIPS CQM
- #326: Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy – measure changes also finalized for MIPS CQM
- #425: Photodocumentation of Cecal Intubation
Two measures were removed from the MIPS program, but similar measures exist for providers who have relied on these measures in the past:
- #154: Falls: Risk Assessment – Removed from the MIPS program, but measure #318: Screening for Future Fall Risk remains available to report as an eCQM
- #337: Psoriasis: Tuberculosis (TB) Prevention for Patients with Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis on a Biological Immune Response Modifier – Removed from the MIPS program, but changes to measure #176: Tuberculosis Screening Prior to First Course Biologic Therapy will allow continued reporting of this quality activity by many dermatologists
11 measures were removed entirely from the MIPS program, most at the request of the measure steward, or for reaching the end of the topped-out lifecycle:
- #21: Perioperative Care: Selection of Prophylactic Antibiotic – First OR Second-Generation Cephalosporin
- #23: Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)
- #44: Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery
- #67: Hematology: Myelodysplastic Syndrome (MDS) and Acute Leukemias: Baseline Cytogenetic Testing Performed on Bone Marrow
- #70: Hematology: Chronic Lymphocytic Leukemia (CLL): Baseline Flow Cytometry
- #195: Radiology: Stenosis Measurement in Carotid Imaging Reports
- #225: Radiology: Reminder System for Screening Mammograms
- #342: Pain Brought Under Control Within 48 Hours
- #429: Pelvic Organ Prolapse: Preoperative Screening for Uterine Malignancy
- #434: Proportion of Patients Sustaining a Ureter Injury at the Time of Pelvic Organ Prolapse Repair
- #444: Medication Management for People with Asthma
Several measures were proposed for removal, but these removals were not finalized for 2022. These are important to note, as it may indicate a short lifespan for these measures. They are on the radar for possible removal in future years:
- #19: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
- #137: Melanoma: Continuity of Care – Recall System
- #144: Oncology: Medical and Radiation – Plan of Care for Pain
- #317: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented – it was also noted that CMS would like to make this an outcome measure in the future

Measures with Substantive Changes

8 measures had significant changes that do not allow for performance comparisons to past years. This means that historical benchmarks will not be used to score these measures in 2022, so these measures can only earn more than 3 points if benchmarks can be established based on the 2022 data that is submitted:
- #65: Appropriate Treatment for Upper Respiratory Infection (URI) – only the MIPS CQM collection type will lose the historical benchmark; historical benchmarks will still be used to score this measure when the eCQM is reported
- #116: Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis [page 2]
- #335: Maternity Care: Elective Delivery or Early Induction Without Medical Indication at < 39 Weeks (Overuse)
- #350: Total Knee Replacement: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy
- #351: Total Knee Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation
- #366: Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- #400: One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk
- #409: Clinical Outcome Post Endovascular Stroke Treatment [page 2]
Two measures had changes that CMS did not conclude were significant enough to remove historical benchmark scoring, but which may affect how providers document the measures:
- #111: Pneumococcal Vaccination Status for Older Adults [page 2]
  - The age range was updated from 65 to 66
  - An exception was added for not receiving the vaccine for medical reasons
  - Only the PPSV23 vaccine (Pneumovax 23) will be acceptable for meeting this measure in 2022 and beyond. Previously, receipt or report of receipt of any pneumonia vaccine met this measure. This change could cause problems for providers who document this measure but do not administer the vaccine, as patients may not be able to provide this level of detail, but EHRs and registries may start requiring it.
- #238: Use of High-Risk Medications in Older Adults [page 2] [page 3]
  - Antipsychotics and benzodiazepines have been added to the list of high-risk medications
73 measures had changes to things like descriptions or definitions, but these changes were not significant enough to warrant removing the historical benchmark scoring for 2022, and most clinicians will not notice a difference in the measures:

For information on important scoring changes to MIPS in 2022, see the article here.