Is MIPS 126 the same as MIPS 126?

Yes. CMS uses zero-padded three-digit Quality IDs (126) in official specifications, while clinicians often search for MIPS 126 or Quality ID 126 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

How do I report MIPS Measure 126 in 2026?

MIPS Measure 126 (Quality ID 126) is reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM) via qualified registry, or Medicare Part B claims where applicable.

Is MIPS 126 a topped-out measure?

Yes, MIPS 126 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 126|Diabetes|2026 Performance Year

2026 MIPS Measure #126: Diabetes Mellitus: Diabetic Foot and Ankle Care Peripheral Neuropathy – Neurological Evaluation

Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months.

ProcessDiabetesEndocrinologyFunctional Assessment

Measure ID:MIPS 126 (Quality ID 126)

Collection:MIPS CQM

Topped Out:Yes

View CMS Spec ↗

Measure Specification

Eligible Population

Patients aged ≥ 18 years on date of encounter

ANDDiagnosis for diabetes on date of encounter

ANDPatient encounter during the performance period

WITHOUTEncounters conducted via telehealth: M1426

Exclusions

G2178Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee; patient has condition that would not allow them to accurately respond to a neurological exam (dementia, Alzheimer’s, etc.); patient has previously documented diabetic peripheral neuropathy with loss of protective sensation

Numerator

Patients who had a lower extremity neurological exam performed at least once within 12 months.

Reporting Codes

Performance Met:

G8404Lower extremity neurological exam performed and documented

Performance Not Met:

G8405Lower extremity neurological exam not performed

○ Exceptions:

G2179Clinician documented that patient had medical reason for not performing lower extremity neurological exam

VBCA Insights

Why This Measure Matters

This measure tracks whether diabetic patients receive regular neurological exams of their feet to detect early nerve damage before serious complications develop. Neuropathy is the leading cause of diabetic foot ulcers and amputations; early detection enables preventive care like proper footwear and foot care education. Test sensation using monofilament plus vibration or temperature annually in all diabetic patients. Refer to podiatry if abnormalities are found.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 126 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM) or through qualified registry submission.

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Specialty Measure Sets

Endocrinology Family Medicine Internal Medicine Physical Therapy/Occupational Therapy Podiatry Preventive Medicine

Related Measures

Diabetes

MIPS 001: Diabetes: Glycemic Status Assessment Greater Than 9%MIPS 117: Diabetes: Eye Exam MIPS 127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of MIPS 488: Kidney Health Evaluation

Endocrinology

MIPS 001: Diabetes: Glycemic Status Assessment Greater Than 9%MIPS 117: Diabetes: Eye Exam MIPS 118: Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE)MIPS 127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of MIPS 336: Maternity Care: Postpartum Follow-up and Care Coordination MIPS 438: Statin Therapy for the Prevention and Treatment of Cardiovascular Disease MIPS 488: Kidney Health Evaluation

Functional Assessment

MIPS 048: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in MIPS 050: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years MIPS 127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of MIPS 178: Rheumatoid Arthritis (RA): Functional Status Assessment MIPS 182: Functional Outcome Assessment MIPS 282: Dementia: Functional Status Assessment MIPS 502: Improvement or Maintenance of Functioning for Individuals with a Mental and/or

Official Resources

📄 CMS Measure Specification (PDF)🔗 QPP Quality Payment Program

Clinical Rationale

Foot ulceration is the most common single precursor to lower extremity amputations among persons with diabetes. Treatment of infected foot wounds accounts for up to one-quarter of all inpatient hospital admissions for people with diabetes in the United States. Peripheral sensory neuropathy in the absence of perceived trauma is the primary factor leading to diabetic foot ulcerations.

Approximately 45-60% of all diabetic ulcerations are purely neuropathic. Other forms of neuropathy may also play a role in foot ulcerations. Motor neuropathy resulting in anterior crural muscle atrophy or intrinsic muscle wasting can lead to foot deformities such as foot drop, equinus, and hammertoes. In people with diabetes, 22.8% have foot problems such as amputations and numbness, compared with 10% of nondiabetics.

Over the age of 40 years old, 30% of people with diabetes have loss of sensation in their feet.

Clinical Recommendations

Recognizing important risk factors and making a logical, treatment-oriented assessment of the diabetic foot requires a consistent and thorough diagnostic approach using a common language. Without such a method, the practitioner is more likely to overlook vital information and to pay inordinate attention to less critical points in the evaluation. A useful examination will involve identification of key risk factors and assignment into appropriate risk category.

Only then can an effective treatment plan be designed and implemented.

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 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.

Evaluation of neurological status in patients with diabetes to assign risk category and therefore have appropriate foot and ankle care to prevent ulcerations and infections ultimately reduces the number and severity of amputations that occur.

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