Is MIPS 291 the same as MIPS 291?

Yes. CMS uses zero-padded three-digit Quality IDs (291) in official specifications, while clinicians often search for MIPS 291 or Quality ID 291 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 291 in 2026?

MIPS Measure 291 (Quality ID 291) 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 291 a topped-out measure?

Yes, MIPS 291 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 291|Dementia|2026 Performance Year

2026 MIPS Measure #291: Assessment of Cognitive Impairment or Dysfunction for Patients with Parkinson’s

Percentage of all patients with a diagnosis of Parkinson’s disease (PD) who were assessed for cognitive impairment or dysfunction once during the measurement period.

ProcessDementiaNeurologyParkinson's Disease

Measure ID:MIPS 291 (Quality ID 291)

Collection:MIPS CQM

Topped Out:Yes

View CMS Spec ↗

Measure Specification

Eligible Population

All patients regardless of age

ANDDiagnosis for Parkinson’s disease

ANDPatient encounter during the performance period

Exclusions

None

Numerator

Patients (or care partner as appropriate) who were assessed for cognitive impairment or dysfunction once during the measurement period.

Reporting Codes

Performance Met:

3720FCognitive impairment or dysfunction assessed

Performance Not Met:

3720F with 8PCognitive impairment or dysfunction was not assessed, reason not otherwise specified

○ Exceptions:

G0036Patient or care partner decline assessment

G0037On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available.

VBCA Insights

Why This Measure Matters

Parkinson's disease affects thinking just as much as movement—about a third of patients develop mild cognitive impairment or dementia. This measure checks whether you're screening for cognitive changes at least once during the year, either through conversation, a quick tool like the Montreal Cognitive Assessment, or referral to neuropsychology. Early detection helps you adjust medications (some worsen cognition), refer for cognitive rehab, and prepare patients and families for changes ahead.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 291 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

Neurology Physical Therapy/Occupational Therapy Speech Language Pathology

Related Measures

Dementia

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 513: Patient Reported Falls and Plan of Care

Neurology

MIPS 268: Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy MIPS 293: Rehabilitative Therapy Referral for Patients with Parkinson’s Disease MIPS 478: Functional Status Change for Patients with Neck Impairments MIPS 513: Patient Reported Falls and Plan of Care

Parkinson's Disease

MIPS 293: Rehabilitative Therapy Referral for Patients with Parkinson’s Disease

Official Resources

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

Clinical Rationale

Cognitive functioning impacts life satisfaction and health-related quality of life. It is anticipated that if assessed on an ongoing basis, cognitive deficits may be identified and addressed in a timely manner. Once identified, such deficits could be treated (or patients referred to appropriate resources) and thereby improve individuals quality of life.

Clinical Recommendations

• The Mini-Mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAM Cog) should be considered as screening tools for dementia in patients with PD (Level B).(4) • An assessment of neuropsychological functioning in a person presenting with parkinsonism suspected of being PD is recommended (Level A) and should include: (I) A collateral history from a reliable carer (II) A brief assessment of cognition (III) Screening for a rapid eye movement (REM) sleep behavior disorder (RBD), psychotic manifestations and severe depression.

(5) • Clinical history should be supplemented by an informant (GPP). A neurological and general physical examination should be performed in all patients with dementia (GPP).(6) • Cognitive assessment is central to diagnosis and management of dementias and should be performed in all patients (Level A). Screening tests are available of good accuracy in the general diagnosis of dementia or have been proposed specifically for the differential diagnosis between the different forms of dementia (GPP).

Neuropsychological assessment should be performed in all patients in the early stages of the disease (Level B) when the cognitive impairment reflects the disruption of specific brain structures. The neuropsychological assessment should include a global cognitive measure and, in addition, more detailed testing of the main cognitive domains including memory, executive functions and instrumental functions (Level C).

(6) • The general practitioner knows the cognitive-behavioral profile of his/her patients and can identify the clinical signs of cognitive decay at their onset, taking also into account the observation of relatives (I/A).(7) • General practitioners should assess all pathological conditions that could cause cognitive disorders (VI/A).(7) • In raising the diagnostic hypothesis of dementia, general practitioners should assess the presence of co- morbidities and identify risk factors due to social isolation (VI/A).

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.

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