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.

🧮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

💡 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 155 Benchmarks

Historical CMS benchmark deciles for MIPS quality measure 155 by collection type. Your performance rate falls into a decile, which determines your measure points (3–10).

MIPS CQMAvg. performance rate: 96.30%Topped Out — 7-point cap

Decile	Performance Rate Range	Points
Decile 1	16.19 - 95.37%	1 – 1.9
Decile 2	95.38 - 99.99%	2 – 2.9
Decile 10	100.00%	10

Specialty Measure Sets

Audiology Family Medicine Geriatrics Internal Medicine Neurology Orthopedic Surgery Otolaryngology Physical Medicine Physical Therapy/Occupational Therapy Podiatry Preventive Medicine Skilled Nursing Facility

Related Measures

Geriatrics

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 181: Elder Maltreatment Screen and Follow-Up Plan MIPS 238: Use of High-Risk Medications in Older Adults MIPS 282: Dementia: Functional Status Assessment MIPS 286: Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia MIPS 288: Dementia: Education and Support of Caregivers for Patients with Dementia MIPS 500: Acute Posterior Vitreous Detachment Appropriate Examination and Follow-up MIPS 501: Acute Posterior Vitreous Detachment and Acute Vitreous Hemorrhage Appropriate MIPS 513: Patient Reported Falls and Plan of Care

Patient Safety

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

Official Resources

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

Clinical Context

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.

Frequently Asked Questions

Who is eligible for MIPS 155?

All patients aged 65 years and older with a history of falls (history of falls is defined as 2 or more falls in the past year or any fall with injury in the past year). Documentation of patient reported history of falls is sufficient.

Is MIPS 155 the same as MIPS 155?

Yes. CMS uses zero-padded three-digit Quality IDs (155) in official specifications, while clinicians often search for MIPS 155 or Quality ID 155 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 155: Falls: Plan of Care?

Submission codes: 0518F (Falls plan of care documented); 0518F with 8P (Falls plan of care not documented, reason not otherwise specified)

What is the NQF number for MIPS Measure 155?

MIPS Measure 155 is associated with CBE/NQF number 101. It can be reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM).

How do I report MIPS Measure 155 in 2026?

MIPS Measure 155 (Quality ID 155) 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 155 a topped-out measure?

Yes, MIPS 155 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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