PM 4 - Glycemic Management Services

Activity Weighting: High
Subcategory Name: Population Management
Description: For outpatient Medicare beneficiaries with diabetes and who are prescribed antidiabetic agents (e.g., insulin, sulfonylureas), MIPS-eligible clinicians and groups must attest to having:

• For the first performance year, at least 60 percent of medical records with documentation of an individualized glycemic treatment goal that: 
  1. Takes into account patient-specific factors, including, at least 
     1. age, 
     2. comorbidities, and 
     3. risk for hypoglycemia, and
     4. is reassessed at least annually. The performance threshold will increase to 75 percent for the second performance year and onward. Clinician would attest that, 60 percent for first year, or 75 percent for the second year, of their medical records that document individualized glycemic treatment represent patients who are being treated for at least 90 days during the performance periods.

Supporting Documentation

1. Diabetic Patients Prescribed Antidiabetic Agents - Total number of outpatients who are diabetic and prescribed antidiabetic agents; and 
2. Documented Percentage of Total with Glycemic Treatment Goals and Assessed at Least Annually - Number of outpatients, who are diabetic and prescribed antidiabetic agents, with documented glycemic treatment goals; and the goals take into account patient-specific factors, including at least age, comorbidities, and risk for hypoglycemia; and are flagged for reassessment in following year.

Resources
2018 Improvement Activities Requirements
2019 Improvement Activities Requirements
2018 MIPS Improvement Activities Fact Sheet
Scores for Improvement Activities for MIPS APMs in the 2018 Performance Period Fact Sheet