2026 MIPS Measure #293: Rehabilitative Therapy Referral for Patients with Parkinson’s Disease

Percentage of all patients with a diagnosis of Parkinson's Disease who were referred to physical, occupational, speech, or recreational therapy once during the measurement period.

This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of Parkinson’s disease seen during the performance period. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Measure Submission:
The quality data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this collection type for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. The coding provided to identify the measure criteria: Denominator or Numerator, may be an example of coding that could be used to identify patients that meet the intent of this clinical topic. When implementing this measure, please refer to the ‘Reference Coding’ section to determine if other codes or code languages that meet the intent of the criteria may also be used within the medical record to identify and/or assess patients. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

All patients with a diagnosis of Parkinson’s disease

DENOMINATOR NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for MIPS CQMs.

All patients regardless of age

AND

Diagnosis for Parkinson’s disease (ICD-10-CM): G20.A1, G20.A2, G20.B1, G20.B2, G20.C

AND

Patient encounter during the performance period (CPT): 90791, 90792, 90839, 92521, 92522, 92523, 92524, 92597, 92605, 92607, 92610, 92611, 92612, 92616, 96105, 96110*, 96112, 96116, 96125, 96130, 96132, 96156, 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99242*, 99243*, 99244*, 99245*, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99421, 99422, 99423, 99483

Patients who were referred to physical, occupational, speech, or recreational therapy once during the measurement period

Performance Met: Referral to physical, occupational, speech, or recreational therapy (G0042)

OR

Denominator Exception: Patient and/or care partner decline referral (G0041)

OR

Denominator Exception: Clinician determines patient does not require referral (G0038)

OR

Denominator Exception: Patient already receiving physical/occupational/speech/recreational therapy during the measurement period (G0040)

OR

Performance Not Met: Patient not referred, reason not otherwise specified (G0039)

For those patients with Parkinson’s disease who have impaired activities of daily living, therapy options such as physical, occupational, and speech therapy should be offered. Rehabilitative therapies play an important role in improving function and quality of life for these patients. Symptomatic therapy can provide benefit for many years. Patients with Parkinson’s disease commonly develop dysarthria.

WJ, Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: neuroprotective strategies and alternative therapies for Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006 Apr 11; 66(7):976-82.

Factor, S. Weiner, W. Parkinson’s disease: Diagnosis and Clinical Management. 2002