Measure ID: MIPS 155|Geriatrics|2026 Performance Year

Falls: Plan of Care

Percentage of patients aged 65 years and older with a history of falls who had a plan of care for falls documented within 12 months.

Process – High PriorityGeriatricsPatient Safety

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

Patients aged ≥ 65 years on date of encounter
ANDPatient screened for future fall risk; documentation of two or more falls in the past year or any fall with injury in the past year: 1100F
ANDPatient encounter during the performance period

Denominator Exclusions1

G9720Hospice services for patient occurred any time during the measurement period

Numerator

Patients who had a plan of care for falls documented within 12 months.

Submission Codes (QDCs)

✓ Performance Met
0518FFalls plan of care documented
✗ Performance Not Met
0518F with 8PFalls plan of care not documented, reason not otherwise specified

Denominator Exceptions

Denominator Exception: Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair (0518F with 1P)

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VBCA Insights

💡Why This Measure Matters

Older patients who've had falls are at high risk for serious injury or decline—but a documented plan can prevent it. This measure flags whether you've created a care plan (covering balance, strength, and gait work) for seniors in your practice with a fall history. Strong performance means you're proactively intervening with the right mix of training and patient education. Setting up a fall-prevention checklist at visits with at-risk seniors makes this standard and efficient.

📖Clinical Rationale

Interventions to prevent future falls should be documented for the patient with 2 or more falls or injurious falls.

📝Clinical Recommendations

The USPSTF recommends exercise or physical therapy to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls. Grade: B Recommendation. The AGS 2010 Clinical Practice Guidelines Recommend: Multifactorial/Multicomponent Interventions to Address Identified Risk(s) and Prevent Falls 1. A strategy to reduce the risk of falls should include multifactorial assessment of known fall risk factors and management of the risk factors identified.

[A] 2. The components most commonly included in efficacious interventions were: a. Adaptation or modification of home environment [A] b. Withdrawal or minimization of psychoactive medications [B] c. Withdrawal or minimization of other medications [C] d. Management of postural hypotension [C] e. Management of foot problems and footwear [C] f. Exercise, particularly balance, strength, and gait training [A] 3.

All older adults who are at risk of falling should be offered an exercise program incorporating balance, gait, and strength training. Flexibility and endurance training should also be offered, but not as sole components of the program. [A] 4. Multifactorial/multicomponent intervention should include an education component complementing and addressing issues specific to the intervention being provided, tailored to individual cognitive function and language.

[C] 5. The health professional or team conducting the fall risk assessment should directly implement the interventions or should assure that the interventions are carried out by other qualified healthcare professionals.

📋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 (QDC) will be used if the measure is submitted more than once.

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