Measure ID: MIPS 008|Heart Failure|2026 Performance Year

Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) ≤ 40% who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge.

ProcessHeart FailureMedication 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 heart failure on date of encounter
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 moderately or severely depressed left ventricular systolic function: G8923
Submission Criteria 2
AND NOTPatients aged ≥ 18 years on date of encounter
ANDDiagnosis for heart failure on date of encounter
ANDPatient encounter during performance period
WITHOUTEncounters conducted via telehealth: M1426
ANDCurrent or prior left ventricular ejection fraction (LVEF) ≤ 40% or documentation of moderately or severely depressed left ventricular systolic function: G8923

Denominator Exclusions1

M1152Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD): M1152 Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD)

Numerator

Criteria 1Patients who were prescribed beta-blocker therapy within a 12-month period when seen in the outpatient setting.

Submission Codes (QDCs)

✓ Performance Met
G8450Beta-blocker therapy prescribed
G8450Beta-blocker therapy prescribed
✗ Performance Not Met
G8452Beta-blocker therapy not prescribed
G8452Beta-blocker therapy not prescribed

Denominator Exceptions

G8451Beta-Blocker Therapy for LVEF ≤ 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons)
G8451Beta-Blocker Therapy for LVEF ≤ 40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons)

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VBCA Insights

💡Why This Measure Matters

This measure tracks whether heart failure patients with reduced ejection fraction receive beta-blocers, drugs that improve survival and reduce hospital readmissions. Beta-blocers are among the most evidence-based treatments for reduced ejection fraction and should be initiated promptly after diagnosis. Start at a low dose and gradually uptitrate to target dose while monitoring blood pressure and heart rate. Outpatient initiation is safe and effective when done systematically.

📖Clinical Rationale

Beta blockers improve survival and reduce hospitalization for patients with stable heart failure and reduced LVEF (HFrEF). Treatment should be initiated as soon as a patient is diagnosed with reduced LVEF and does not have prohibitively low systemic blood pressure, fluid overload, or recent treatment with an intravenous positive inotropic agent. Beta blockers have also been shown to lessen the symptoms of heart failure, improve the clinical status of patients, and reduce future clinical deterioration.

Despite these benefits, use of beta blockers in eligible patients remains suboptimal.

📝Clinical Recommendations

In patients with HFrEF, with current or previous symptoms, use of 1 of the 3 beta blockers proven to reduce mortality (e.g., bisoprolol, carvedilol, sustained-release metoprolol succinate) is recommended to reduce mortality and hospitalizations. (Class 1, Level of Evidence A) (AHA/ACC/HFSA, 2022). Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only Beta-blocker therapy) Table 1: Drugs Commonly Used for Stage C HFrEF Beta Blocker Therapy Drug Initial Daily Dose(s) Maximum Dose(s)Total Daily Target Dose Mean Doses Achieved in Clinical Trials Beta Blockers Bisoprolol 1.

25 mg once 10 mg once 8.6 mg/d Carvedilol 3.125 mg twice 25-50 mg twice 37 mg/d Carvedilol CR 10 mg once 80 mg once N/A Metoprolol succinate extended release (metoprolol CR/XL) 12.5 to 25 mg once 200 mg once 159 mg/d For the hospitalized patient: In patients with HFrEF requiring hospitalization, preexisting GDMT* should be continued and optimized to improve outcomes, unless contra-indicated (Class 1, Level of Evidence B-NR) (AHA/ACC/HFSA, 2022).

In patients with HFrEF, GDMT should be initiated during hospitalization after clinical stability is achieved (Class 1, Level of Evidence B-NR) (AHA/ACC/HFSA, 2022). In patients with HFrEF, if discontinuation of GDMT is necessary during hospitalization, it should be reinitiated and further optimized as soon as possible (Class 1, Level of Evidence B-NR) (AHA/ACC/HFSA, 2022).

📋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 HF seen in the outpatient setting OR 2) All patients with a diagnosis of HF and discharged from hospital Both submission criteria should be submitted as appropriate.

For the purposes of MIPS implementation, this patient-process measure is submitted a minimum of once per patient during the performance period. The most advantageous quality data code will be used if the measure is submitted more than once. Only patients who had at least two denominator eligible visits during the performance period will be counted for Submission Criteria 1.

When submitting CPT code 99238 and 99239, it is recommended the measure be submitted each time the code is submitted for hospital discharge.

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