Who is eligible for MIPS 116?

All patients aged 3 months or older with an outpatient visit, emergency department (ED) visit, observation visit, telephone visit, e-visit or virtual check-in with a diagnosis of acute bronchitis/bronchiolitis during the measurement period.

What codes do I submit for MIPS 116: Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis?

Submission codes: 4124F (Antibiotic neither prescribed nor dispensed); 4120F (Antibiotic prescribed or dispensed)

Is MIPS 116 a topped-out measure?

Yes, MIPS 116 is currently topped out, which means most clinicians perform well on this measure and it may be subject to a 7-point scoring cap.

Measure ID: MIPS 116|Appropriate Use|2026 Performance Year

Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis

The percentage of episodes for patients ages 3 months and older with a diagnosis of acute bronchitis/bronchiolitis that did not result in an antibiotic dispensing event.

Process – High PriorityAppropriate UsePulmonology

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

Patients 3 months of age and older on date of encounter

ANDDiagnosis for acute bronchitis/bronchiolitis

ANDPatient encounter during the performance period

WITHOUTPlace of Service (POS): 21

Denominator Exclusions4

G2176Outpatient, ED or Observation visits that result in an inpatient admission

G2177Acute bronchitis/bronchiolitis episodes when the patient had a new or refill prescription of antibiotics (Table 1) in the 30 days prior to the episode date

G9712Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, Lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/UTI, acne, HIV disease/asymptomatic HIV, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis)

G9713Patients who use hospice services any time during the measurement period: G9713 Reference Medication Table: Table 1: Denominator Exclusion for a new or refill prescription of antibiotics [G2177] and Numerator Option for antibiotic prescribed or dispensed [4120F] is defined by the following antibiotic medications only: Description Prescription Aminoglycosides Amikacin Gentamicin Streptomycin Tobramycin Description Prescription Aminopenicillins Amoxicillin Ampicillin Beta-lactamase inhibitors Amoxicillin-clavulanate Ampicillin- sulbactam Piperacillin-tazobactam First-generation cephalosporins Cefadroxil Cephalexin Cefazolin Fourth-generation cephalosporins Cefepime Lincomycin derivatives Clindamycin Lincomycin Macrolides Azithromycin Clarithromycin Erythromycin Miscellaneous antibiotics Aztreonam Chloramphenicol Dalfopristin-quinupristin Daptomycin Linezolid Metronidazole Vancomycin Natural penicillins Penicillin G benzathine- procaine Penicillin G potassium Penicillin G procaine Penicillin G sodium Penicillin V potassium Penicillin G benzathine Penicillinase resistant penicillins Dicloxacillin Nafcillin Oxacillin Quinolones Ciprofloxacin Gemifloxacin Levofloxacin Moxifloxacin Ofloxacin Rifamycin derivatives Rifampin Second generation cephalosporin Cefaclor Cefotetan Cefoxitin Cefprozil Cefuroxime Sulfonamides Sulfadiazine Sulfamethoxazole-trimethoprim Tetracyclines Doxycycline Tetracycline Minocycline Third generation cephalosporins Cefdinir Cefpodoxime Cefixime Cefotaxime Ceftriaxone Ceftazidime Urinary anti-infectives Fosfomycin Nitrofurantoin Nitrofurantoin macrocrystals- monohydrate Trimethoprim

Numerator

Patients who were not prescribed or dispensed antibiotics (Table 1) on or within 3 days of the initial date of service.

Submission Codes (QDCs)

✓ Performance Met

4124FAntibiotic neither prescribed nor dispensed

✗ Performance Not Met

4120FAntibiotic prescribed or dispensed

Denominator Exceptions

None — this measure has no denominator exceptions.

🧮MIPS Score Simulator

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

Your Performance Rate:%Benchmarks vary by collection type

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VBCA Insights

💡Why This Measure Matters

This measure tracks prescriptions of antibiotics for acute bronchitis, which is almost always viral and doesn't benefit from antibiotics. Unnecessary antibiotics contribute to resistant bacteria and expose patients to side effects; supportive care is the appropriate treatment. Reassure patients that cough from bronchitis typically resolves over 1-2 weeks without antibiotics. Avoid prescribing unless there's evidence of bacterial superinfection or underlying COPD.

📖Clinical Rationale

Antibiotics are most often inappropriately prescribed for acute bronchitis. This measure assesses the percentage of episodes among members ages 3 months and older with a diagnosis of acute bronchitis/bronchiolitis that did not result in an antibiotic dispensing event. Antibiotics are not indicated in clinical guidelines for treating with acute bronchitis who do not have a comorbidity or other infection for which antibiotics may be appropriate.

Inappropriate antibiotic treatment of patients with acute bronchitis is of clinical concern, especially since misuse and overuse of antibiotics lead to antibiotic drug resistance). Acute bronchitis consistently ranks among the 10 conditions that account for most ambulatory office visits to U.S. physicians; furthermore, while the vast majority of acute bronchitis cases (more than 90%) have a nonbacterial cause, antibiotics are inappropriately prescribed 65%–80% of the time.

Inappropriate antibiotic use can be addressed by reminding providers of clinical guideline recommendations and providing feedback about their prescribing behaviors. In addition, use of patient education interventions can discourage seeking antibiotics for viral conditions (such as the common cold), or without confirmatory tests such as group A strep test for pharyngitis.

📝Clinical Recommendations

Clinical guidelines do not support antibiotic treatment of otherwise healthy adults with acute bronchitis/bronchiolitis due to the viral origin of acute bronchitis/bronchiolitis. Patients with chronic bronchitis, COPD or other chronic comorbidity may be treated with antibiotics and are therefore excluded from the measure denominator (Gonzales et al., 2001).

📋Implementation Notes

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this episode measure is submitted once for each occurrence of a particular illness or condition during the performance period.

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Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis

Measure Specification

Denominator (Eligible Population)

Denominator Exclusions4

Numerator

Submission Codes (QDCs)

Denominator Exceptions

🧮MIPS Score Simulator

💡Why This Measure Matters

📖Clinical Rationale

📝Clinical Recommendations

📋Implementation Notes

Measure Details

Specialty Sets

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Official Resources

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