Measure ID: MIPS 180·Rheumatology·2026 Performance Year

2026 MIPS Measure #180: Rheumatoid Arthritis (RA): Glucocorticoid Management

Percentage of patients aged 18 years and older with two or more encounters with a diagnosis of rheumatoid arthritis (RA) at least 90 days apart who have been assessed for glucocorticoid use and, for those on prolonged doses of prednisone >5 mg daily (or equivalent) with improvement or no change in disease activity, documentation of glucocorticoid management plan during the performance period.

ProcessRheumatologyMedication Management

Measure ID:MIPS 180 (Quality ID 180)

Collection:MIPS CQM

Topped Out:Yes

View CMS Spec ↗

Measure Specification

Eligible Population

Patients aged ≥ 18 years on date of encounter

ANDDiagnosis for rheumatoid arthritis(RA)

ANDPatient encounter during the performance period

ANDAn additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance period: M1376

ANDGlucocorticoid Management Plan documented (0540F)

ANDPatient receiving > 5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity (G2113)

ANDPatient receiving >5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity (G2113)

Exclusions

None

Numerator

Patients who have been assessed for glucocorticoid use and for those on prolonged doses of prednisone > 5 mg daily (or equivalent) with improvement or no change in disease activity, documentation of a glucocorticoid management plan during the performance period.

Reporting Codes

Performance Met:

4192FPatient not receiving glucocorticoid therapy

G2112Patient receiving ≤5 mg daily prednisone (or equivalent), or RA activity is worsening, or glucocorticoid use is for less than 6 months

G2113Patient receiving > 5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity

Performance Not Met:

4194F with 8PGlucocorticoid dose was not documented, reason not otherwise specified

0540F with 8PGlucocorticoid management plan not documented, reason not otherwise specified

○ Exceptions:

Documentation of medical reason(s) for not documenting glucocorticoid management plan (i.e., glucocorticoid prescription is for a medical condition other than RA) (0540F with 1P)

VBCA Insights

Why This Measure Matters

Long-term steroids for RA carry real risks—bone loss, infection, metabolic effects—so they should be used sparingly and always with a plan to taper. This measure verifies you've documented steroid assessment and a management plan for RA patients taking prednisone over 5 mg daily with stable or improving disease. If a patient's doing well, the plan should be explicit: continue, taper, or transition to another agent. This documentation keeps steroid use honest and purposeful.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 180 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 180 Benchmarks

Historical CMS benchmark deciles for MIPS quality measure 180 by collection type. Your performance rate falls into a decile, which determines your measure points (3–10).

MIPS CQMAvg. performance rate: 92.89%Topped Out — 7-point cap

Decile	Performance Rate Range	Points
Decile 1	13.67 - 78.43%	1 – 1.9
Decile 2	78.44 - 90.76%	2 – 2.9
Decile 3	90.77 - 92.95%	3 – 3.9
Decile 4	92.96 - 96.63%	4 – 4.9
Decile 5	96.64 - 99.79%	5 – 5.9
Decile 6	99.80 - 99.99%	6 – 6.9
Decile 10	100.00%	10

Specialty Measure Sets

Orthopedic Surgery Rheumatology

Related Measures

Rheumatology

MIPS 176: Tuberculosis Screening Prior to First Course of Biologic and/or Immune Response MIPS 177: Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity MIPS 178: Rheumatoid Arthritis (RA): Functional Status Assessment

Medication Management

MIPS 005: Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or MIPS 007: Coronary Artery Disease (CAD): Beta-Blocker Therapy – Prior Myocardial MIPS 008: Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic MIPS 118: Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE)MIPS 130: Documentation of Current Medications in the Medical Record MIPS 268: Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy MIPS 410: Psoriasis: Clinical Response to Systemic Medications MIPS 468: Continuity of Pharmacotherapy for Opioid Use Disorder (OUD)MIPS 489: Adult Kidney Disease: Angiotensin Converting Enzyme (ACE) Inhibitor or MIPS 490: Appropriate Intervention of Immune-Related Diarrhea and/or Colitis in Patients Treated

Official Resources

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

Clinical Context

Clinical Rationale

Glucocorticoids are an important part of RA treatment as they inhibit inflammation and may control synovitis. However, long-term use of glucocorticoids, especially at high doses, should be avoided, due to the potential health complications. Monitoring length and dose of glucocorticoid treatment for patients with RA is integral to making other clinical decisions.

Clinical Recommendations

Low-dose oral glucocorticoids and local injections of glucocorticoids are highly effective for relieving symptoms in patients with active RA. The benefits of low-dose systemic glucocorticoids, however, should always be weighed against their adverse effects. The adverse effects of long-term oral glucocorticoids at low doses are protean and include osteoporosis, hypertension, weight gain, fluid retention, hyperglycemia, cataracts, and skin fragility, as well as the potential for premature atherosclerosis.

These adverse effects should be considered and should be discussed in detail with the patient before glucocorticoid therapy is begun. For long term disease control, the glucocorticoid dosage should be kept to a minimum. For the majority of patients with RA, this means equal or less than 10 mg of prednisone per day. (ACR, 2002) Grijalva, et al found nearly two-fold greater serious infection (OR1.

78 1.47,2.15) at 5-10 mg of prednisone in RA as reported in JAMA 2011 Dec 7;306(21):2331-9. doi: 10.1001/jama.2011.1692. Epub 2011 Nov 6. Because of the dangers to patients associated with being on 5 to 10 mg doses of prednisone, optimal treatment is to aim for a dosage less than or equal to 5 mg.

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 for the performance period. The most advantageous quality data code will be used if the measure is submitted more than once.

Frequently Asked Questions

Who is eligible for MIPS 180?

Patients aged 18 years and older with two or more RA diagnoses documented at least 90 days apart with at least one encounter with an RA diagnosis occurring during the performance period and an additional encounter with an RA diagnosis occurring in the performance period or prior performance period. Definitions: Encounter – An encounter during the performance period where one of the CPT or HCPCS codes listed in the patient encounter criteria is used. Additional encounter – An additional encounter during the performance period or prior performance period where one of the CPT or HCPCS codes listed in the patient encounter is used to confirm an RA diagnosis with ICD-10-CM diagnosis codes as listed in the Denominator criteria.

Is MIPS 180 the same as MIPS 180?

Yes. CMS uses zero-padded three-digit Quality IDs (180) in official specifications, while clinicians often search for MIPS 180 or Quality ID 180 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 180: Rheumatoid Arthritis (RA): Glucocorticoid Management?

Submission codes: 4192F (Patient not receiving glucocorticoid therapy); G2112 (Patient receiving ≤5 mg daily prednisone (or equivalent), or RA activity is worsening, or glucocorticoid use is for less than 6 months); G2113 (Patient receiving > 5 mg daily prednisone (or equivalent) for longer than 6 months, and improvement or no change in disease activity); 4194F with 8P (Glucocorticoid dose was not documented, reason not otherwise specified); 0540F with 8P (Glucocorticoid management plan not documented, reason not otherwise specified)

How do I report MIPS Measure 180 in 2026?

MIPS Measure 180 (Quality ID 180) 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 180 a topped-out measure?

Yes, MIPS 180 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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