Measure ID: MIPS 007|Cardiology|2026 Performance Year

Coronary Artery Disease (CAD): Beta-Blocker Therapy – Prior Myocardial

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF ≤ 40% who were prescribed beta-blocker therapy.

ProcessCardiologyMedication Management

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

Submission Criteria 1
Patients aged ≥ 18 years on date of encounter
ANDDiagnosis for coronary artery disease on date of encounter
ORHistory of cardiac surgery
ANDPatient encounter during performance period – to be used for numerator evaluation
ANDAt least one additional patient encounter during performance period
ANDCurrent or prior left ventricular ejection fraction (LVEF) ≤ 40% or documentation of moderate or severe LVSD: G8694
ORDenominator Exception: Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., allergy, intolerance, other medical reasons) (G9190)
ORDenominator Exception: Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons) (G9191)
ORPerformance Not Met: Beta-blocker therapy not prescribed, reason not given (G9188)
Submission Criteria 2
ORSUBMISSION CRITERIA 2: ALL PATIENTS WITH A DIAGNOSIS OF CAD OR HISTORY OF CARDIAC SURGERY WHO HAVE A PRIOR (WITHIN THE PAST 3 YEARS) MI DENOMINATOR (CRITERIA 2): All patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have prior (within the past 3 years) MI
ANDDiagnosis for coronary artery disease on date of encounter
ORHistory of cardiac surgery
ANDDiagnosis for myocardial infarction – includes patient that had a prior (within the past 3 years) myocardial infarction
ANDPatient encounter during performance period – to be used for numerator evaluation
ANDAt least one additional patient encounter during performance period
ORDenominator Exception: Documentation of medical reason(s) for not prescribing beta- blocker therapy (e.g., allergy, intolerance, other medical reasons) (4008F with 1P)
ORDenominator Exception: Documentation of patient reason(s) for not prescribing beta- blocker therapy (e.g., patient declined, other patient reasons) (4008F with 2P)
ORPerformance Not Met: Beta-blocker therapy not prescribed, reason not otherwise specified (4008F with 8P)

Denominator Exclusions

None

Numerator

Criteria 1Patients who were prescribed beta-blocker therapy.

Submission Codes (QDCs)

✓ Performance Met
G9189Beta-blocker therapy prescribed or currently being taken
4008FBeta-blocker therapy prescribed or currently being taken
✗ Performance Not Met
G9188Beta-blocker therapy not prescribed, reason not given
4008F with 8PBeta-blocker therapy not prescribed, reason not otherwise specified

Denominator Exceptions

G9190Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., allergy, intolerance, other medical reasons)
G9191Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons)
Documentation of medical reason(s) for not prescribing beta- blocker therapy (e.g., allergy, intolerance, other medical reasons) (4008F with 1P)
Documentation of patient reason(s) for not prescribing beta- blocker therapy (e.g., patient declined, other patient reasons) (4008F with 2P)

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VBCA Insights

💡Why This Measure Matters

This measure ensures patients with coronary artery disease who have had a heart attack or have weakened heart function are on beta-blockers, which reduce chest pain and lower mortality risk. Beta-blockers are lifesaving in this population, particularly after MI or when ejection fraction is reduced. Prescribe cardioselective beta-blockers early and maintain them long-term unless contraindicated. Dose optimization and adherence monitoring are important for maximizing benefit.

📖Clinical Rationale

For patients with coronary artery disease (CAD), beta-blockers are recommended for 3 years after myocardial infarction or acute coronary syndrome. Beta-blockers, particularly carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce risk of death, are recommended indefinitely for patients with CAD and LV systolic dysfunction.

These agents have proven efficacy in reducing angina onset and improving the ischemic threshold during exercise. In patients who have suffered an MI, beta-blockers significantly reduce deaths and recurrent MIs. Nonadherence to cardio protective medications is prevalent among outpatients with CAD and can be associated with a broad range of adverse outcomes, including all-cause and cardiovascular mortality, cardiovascular hospitalizations, and the need for revascularization procedures.

This measure is intended to promote beta-blocker usage in select patients with CAD.

📝Clinical Recommendations

Beta-blocker therapy should be started and continued for 3 years in all patients with normal LV function after MI or ACS. (Class I, Level of Evidence: B) (ACCF/AHA/ACP/AATS/PCNA/SCAI/STS, 2012). Beta-blocker therapy should be used in all patients with LV systolic dysfunction (EF ≤ 40%) with heart failure or prior MI, unless contraindicated. (Use should be limited to carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce risk of death.

) (Class I, Level of Evidence: A) (ACCF/AHA/ACP/AATS/PCNA/SCAI/STS, 2012). In patients with CCD and LVEF ≤ 40% with or without previous MI, the use of beta-blocker therapy is recommended to reduce the risk of future MACE, including cardiovascular death.

📋Implementation Notes

This measure contains two strata defined by two submission criteria. This measure produces a single performance rate using a weighted average. There are 2 Submission Criteria for this measure: 1) All patients with a diagnosis of CAD or history of cardiac surgery who have a current or prior LVEF ≤ 40% OR 2) All patients with a diagnosis of CAD or history of cardiac surgery who have a prior (within the past 3 years) MI Only patients who had at least two denominator eligible visits during the performance period will be counted for Submission Criteria 1 and Submission Criteria 2 of this measure.

The MIPS eligible clinician should submit data on one of the submission criteria, depending on the clinical findings. If the patient has CAD or history of cardiac surgery and a current or prior LVEF ≤ 40% (or moderate or severe LVSD), use Submission Criteria 1. If the patient has CAD or history of cardiac surgery and has a prior (within the past 3 years) MI, use Submission Criteria 2.

The 3-year lookback period for the prior MI should be from the time of the encounter that is used to qualify for the denominator and evaluate the numerator. If the patient has had an MI within the past 3 years and has a current or prior LVEF ≤ 40% (or moderate or severe LVSD), the MIPS eligible clinician should submit quality data codes for Submission Criteria 1 and this will count as appropriate submission for this patient.

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