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

2026 MIPS Measure #008: 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
Measure ID:MIPS 008 (Quality ID 8)
eCQM:CMS144v14
CBE:83
Collection:MIPS CQM, eCQM
Topped Out:Yes
View CMS Spec ↗

Measure Specification

This measure produces 2 performance rates. Each rate has its own eligible population, numerator, and reporting codes.

Rate 1
Eligible Population
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
Exclusions
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
Patients who were prescribed beta-blocker therapy within a 12-month period when seen in the outpatient setting.
Reporting Codes

Performance Met:

G8450Beta-blocker therapy prescribed

Performance Not Met:

G8452Beta-blocker therapy not prescribed

○ 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)
Rate 2
Eligible Population
Patients 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
Exclusions
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)
Reporting Codes

Performance Met:

G8450Beta-blocker therapy prescribed

Performance Not Met:

G8452Beta-blocker therapy not prescribed

○ 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)
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.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 008 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM), as an eCQM, or through qualified registry submission.

🧮MIPS Score Simulator

Estimate only — actual CMS scoring may vary based on reporting method, data completeness, and annual rule updates.

%Benchmarks vary by collection type
💡 Tip: Enter your performance rate to compare MIPS points across all collection types. The same rate can score differently depending on how you submit.

2026 MIPS 008 Benchmarks

Historical CMS benchmark deciles for MIPS quality measure 008 by collection type. Your performance rate falls into a decile, which determines your measure points (3–10).

MIPS CQMAvg. performance rate: 98.50%Topped Out — 7-point cap
DecilePerformance Rate RangePoints
Decile 169.05 - 95.78%1 – 1.9
Decile 295.79 - 99.99%2 – 2.9
Decile 10100.00%10
eCQMAvg. performance rate: 91.56%
DecilePerformance Rate RangePoints
Decile 157.14 - 83.32%1 – 1.9
Decile 283.33 - 87.92%2 – 2.9
Decile 387.93 - 90.31%3 – 3.9
Decile 490.32 - 92.18%4 – 4.9
Decile 592.19 - 93.64%5 – 5.9
Decile 693.65 - 94.73%6 – 6.9
Decile 794.74 - 95.64%7 – 7.9
Decile 895.65 - 96.66%8 – 8.9
Decile 996.67 - 98.14%9 – 9.9
Decile 10>= 98.15%10

Related Measures

Clinical Context

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.

Frequently Asked Questions

Who is eligible for MIPS 008?

DENOMINATOR (CRITERIA 1): All patients aged 18 years and older with a diagnosis of heart failure with a current or prior LVEF ≤ 40%. DENOMINATOR (CRITERIA 2): All patients aged 18 years and older with a diagnosis of heart failure with a current or prior LVEF ≤ 40%.

Is MIPS 8 the same as MIPS 008?

Yes. CMS uses zero-padded three-digit Quality IDs (008) in official specifications, while clinicians often search for MIPS 8 or Quality ID 8 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

What codes do I submit for MIPS 008: Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic?

Submission codes: G8450 (Beta-blocker therapy prescribed); G8450 (Beta-blocker therapy prescribed); G8452 (Beta-blocker therapy not prescribed); G8452 (Beta-blocker therapy not prescribed)

What is the NQF number for MIPS Measure 008?

MIPS Measure 008 is associated with CBE/NQF number 83. It is also identified as eCQM CMS144v14. It can be reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM).

How do I report MIPS Measure 008 in 2026?

MIPS Measure 008 (Quality ID 8) is reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM) via qualified registry, eCQM, or Medicare Part B claims where applicable.

Is MIPS 008 a topped-out measure?

Yes, MIPS 008 is currently topped out, which means most clinicians perform well on this measure and it may be subject to a 7-point scoring cap.

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