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2026 MIPS Measure #305: Initiation and Engagement of Substance Use Disorder Treatment

Quality ID305
eMeasure IDCMS137v14
NQFNone
High-Priority MeasureYes
Specifications
Measure TypeProcess
MVP IDYes (MVP ID: M0005, M1369)
Specialty
Behavioral Health Clinical Social Work Family Medicine Internal Medicine Mental Pediatrics

Measure Description

Percentage of patients 13 years of age and older with a new substance use disorder (SUD) episode who received the following (Two rates are reported):
a. Percentage of patients who initiated treatment, including either an intervention or medication for the treatment of SUD, within 14 days of the new SUD episode.
b. Percentage of patients who engaged in ongoing treatment, including two additional interventions or medication treatment events for SUD, or one long-acting medication event for the treatment of SUD, within 34 days of the initiation.

Measure Submission Type

eCQM

Rationale

There are more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition. In 2021, 46.3 million individuals in the U.S. age 12 or older (16.5 percent of the population) met the diagnosis criteria for having an SUD within the past year (Substance Abuse and Mental Health Services Administration [SAMHSA], 2022). Despite the high prevalence of SUD in the U.S., 94 percent of individuals aged 12 or older with an SUD did not receive any treatment (SAMHSA, 2022).

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