MIPS #236 Controlling High Blood Pressure

2025: Changes to denominator exclusion criteria highlighted below. Coding updates in Practice Insights are pending but will be retroactive to 1/1/25.

MEASURE DESCRIPTION

Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period

 Numerator

Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period

 Denominator

Patients 18-85 years of age by the end of the measurement period who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period

 Denominator Exclusion

• Patients with evidence of end-stage renal disease (ESRD), dialysis, or renal transplant before or during the measurement period.

• Patients with a diagnosis of pregnancy during the measurement period.

• Patients 66 and older by the end of the measurement period who are living long-term in a nursing home any time on or before the end of the measurement period.

• Patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:

  • Advanced illness with two outpatient encounters during the measurement period or the year prior

  • OR advanced illness with one inpatient encounter during the measurement period or the year prior

  • OR taking dementia medications during the measurement period or the year prior

• Patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period.

• Patients receiving hospice or palliative care for any part of the measurement period.

Numerator Exclusion

None

 Scoring

1-10 points.

RESOURCES

2025 eCQM Measure Specifications link