2026 MIPS Measure #205: Sexually Transmitted Infection (STI) Testing for People with HIV

Percentage of patients 13 years of age and older with a diagnosis of HIV who had tests for syphilis, gonorrhea, and chlamydia performed within the performance period.

This measure is to be submitted a minimum of once per performance period for patients with HIV seen during the performance period. This measure is intended to reflect the quality of services provided for the primary management of patients with HIV. 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.

NOTE: Patient encounters for this measure conducted via telehealth (including but not limited to encounters coded with GQ, GT, 95, POS 02, POS 10) are allowable. Please note that effective January 1, 2025, while a measure may be denoted as telehealth eligible, specific denominator codes within the encounter may no longer be eligible due to changes outlined in the CY 2024 PFS Final Rule List of Medicare Telehealth Services.

All patients 13 years of age and older at the start of the performance period with a diagnosis of HIV before the end of the performance period with an eligible encounter during the performance period

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.

Patients aged ? 13 years at the start of the performance period

AND

Diagnosis for HIV before the end of the performance period (ICD-10-CM): B20, B97.35, Z21, O98.711, O98.712, O98.713, O98.719, O98.72, O98.73

AND

Patient encounters during the performance period (CPT or HCPCS): 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 98016, 98966, 98967, 98968, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99242*, 99244*, 99245*, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99381*, 99382*, 99383*, 99384*, 99385*, 99386*, 99387*, 99391*, 99392*, 99393*, 99394*, 99395*, 99396*, 99397*, 99429*, G0402, G0438, G0439

Patients who were tested for each of the following at least once during the performance period: syphilis, gonorrhea, and chlamydia

NUMERATOR NOTE: Submit G9228 when results are documented for all of the 3 screenings

Performance Met: Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings) (G9228)

OR

Performance Not Met: Chlamydia, gonorrhea, and syphilis not screened, reason not given (G9230)

In 2024, the combined total number of cases of chlamydia, gonorrhea, and syphilis declined 9% from 2023, down a third consecutive year. There were still more than 2.2 million reported STIs in 2024, and compared to a decade ago, overall cases are 13% higher; congenital syphilis is nearly 700% higher (CDC, 2025). CDC data from 2023 indicates that 46% of people with HIV were tested for chlamydia, gonorrhea, and syphilis in the 12-month period (CDC, 2024). In 2022, men who have sex with men accounted for 45% of all make primary and secondar syphilis and approximately 36% of men who have sex with men with primary and secondary syphilis also had HIV (CDC, 2023). Chlamydia and gonorrhea infections among women can result in pelvic inflammatory disease, ectopic pregnancy, and infertility. This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).