Measure ID: MIPS 155|Geriatrics|2026 Performance Year

2026 MIPS Measure #155: 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
Measure ID:MIPS 155 (Quality ID 155)
CBE:101
Collection:MIPS CQM
Topped Out:Yes
View CMS Spec ↗

Measure Specification

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
Exclusions
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.
Reporting Codes

Performance Met:

0518FFalls plan of care documented

Performance Not Met:

0518F with 8PFalls plan of care not documented, reason not otherwise specified

○ Exceptions:

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)
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.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 155 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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Related Measures

Patient Safety
MIPS 130: Documentation of Current Medications in the Medical RecordMIPS 145: Radiology: Exposure Dose Indices Reported for Procedures Using FluoroscopyMIPS 164: Coronary Artery Bypass Graft (CABG): Prolonged IntubationMIPS 168: Coronary Artery Bypass Graft (CABG): Surgical Re-ExplorationMIPS 181: Elder Maltreatment Screen and Follow-Up PlanMIPS 259: Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-RupturedMIPS 275: Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status BeforeMIPS 286: Dementia: Safety Concern Screening and Follow-Up for Patients with DementiaMIPS 351: Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular RiskMIPS 354: Anastomotic Leak InterventionMIPS 355: Unplanned Reoperation within the 30-Day Postoperative PeriodMIPS 357: Surgical Site Infection (SSI)MIPS 374: Closing the Referral Loop: Receipt of Specialist ReportMIPS 384: Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the OperatingMIPS 385: Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity ImprovementMIPS 392: Cardiac Tamponade and/or Pericardiocentesis Following Atrial FibrillationMIPS 393: Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation,MIPS 413: Door to Puncture Time for Endovascular Stroke TreatmentMIPS 422: Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ ProlapseMIPS 432: Proportion of Patients Sustaining a Bladder or Bowel Injury at the time of any PelvicMIPS 513: Patient Reported Falls and Plan of Care

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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