Measure ID: MIPS 340·HIV·2026 Performance Year

2026 MIPS Measure #340: HIV Annual Retention in Care

Percentage of patients, regardless of age, with a diagnosis of Human Immunodeficiency Virus (HIV) before or during the first 240 days of the performance period who had at least two eligible encounters or at least one eligible encounter and one HIV viral load test that were at least 90 days apart within the performance period.

Process – High PriorityHIVCare Coordination
Measure ID:MIPS 340 (Quality ID 340)
eCQM:CMS1157v2
Collection:MIPS CQM, eCQM
Topped Out:No
View CMS Spec ↗

Measure Specification

Eligible Population
Patients, regardless of age
ANDDiagnosis of HIV before or during the first 240 days of the performance period
ANDPatient encounter during the performance period
Exclusions

None

Numerator
Number of patients who had at least one eligible encounter and one HIV viral load test at least 90 days apart during the performance period, or who had at least two eligible encounters at least 90 days apart during the performance period _NUMERATOR NOTE:_ A patient would be included in the measure numerator if they have either 1) two eligible encounters at least 90 days apart, or 2) one eligible encounter and one viral load test at least 90 days apart from each other. The encounter or encounters that cause a patient to be included in the numerator do not need to include the encounter that caused the patient to be included in the denominator.
Reporting Codes

Performance Met:

G9247Patient had two eligible encounters at least 90 days apart or one eligible encounter and one HIV viral load test at least 90 days apart

Performance Not Met:

G9246Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one HIV viral load test at least 90 days apart
VBCA Insights

Why This Measure Matters

HIV patients who fall out of care stop taking medications, develop resistance, and face AIDS or death. This measure ensures patients with HIV stay in your clinic or care system with at least two visits or one visit plus a viral load test, spaced 90 days apart, each year. Missing visits are a red flag: reach out proactively, address barriers (transportation, side effects, stigma), and re-engage patients early. Consistent retention is the foundation of successful HIV treatment.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 340 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM), as an eCQM, or through qualified registry submission.

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2026 MIPS 340 Benchmarks

Historical CMS benchmark deciles for MIPS quality measure 340 by collection type. Your performance rate falls into a decile, which determines your measure points (3–10).

MIPS CQM
DecilePerformance Rate RangePoints
eCQM
DecilePerformance Rate RangePoints

Clinical Context

Clinical Rationale

“Retention in care should be routinely monitored. There are various ways to measure retention, including measures based on attended visits over a defined period of time (constancy measures), and measures based on missed visits. Both approaches are valid and independently predict survival. Missed visits and a prolonged time since last visit are relatively easy to measure and should trigger efforts to retain or re-engage a person in care.

Constancy measures (e.g., at least two visits that are at least 90 days apart over 1 year, or at least one visit every 6 months over the last 2 years), can be used as clinic quality assurance measures.

Clinical Recommendations

“HIV treatment adherence includes initiating care with an HIV provider (linkage to care), regularly engaging in appointments (retention in care), and adhering to antiretroviral therapy (ART).…This low rate of viral suppression is primarily due to poor adherence to clinic appointments and ART….Knowledgeable providers and high-quality system processes are vital in promoting rapid linkage and sustained retention in care and adherence to ART….

Finally, clinicians should recognize that adherence is a complex behavior requiring knowledge, motivation, memory, behavior change, external resources, and successful and persistent interaction with complex and, sometimes, challenging health care systems. The patient–provider relationship is central to improving HIV care engagement and adherence to treatment.

Providers must recognize that adherence is a collaborative effort between clinicians and people with HIV. "Retention in care should be routinely monitored. There are various ways to measure retention, including measures based on attended visits over a defined period of time (constancy measures), and measures based on missed visits. Both approaches are valid and independently predict survival.

Missed visits and a prolonged time since last visit are relatively easy to measure and should trigger efforts to retain or re-engage a person in care. Constancy measures (e.g., at least two visits that are at least 90 days apart over 1 year, or at least one visit every 6 months over the last 2 years), can be used as clinic quality assurance measures.

” (DHHS, Adult, 2025) “After initiation of ART or after a change in antiretroviral (ARV) regimen, children should be evaluated for treatment adherence and clinical adverse effects within 1 to 2 weeks; laboratory testing for viral load response and toxicity is recommended at 2 to 4 weeks after treatment initiation or change in ARV regimen and every 3 to 4 months thereafter.

“Clinicians and multidisciplinary teams should schedule frequent clinical in-person and/or telemedicine visits to monitor patients closely during the first few months after initiating a new ARV regimen.

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 340?

Patients, regardless of age, with a diagnosis of HIV before or during the first 240 days of the performance period who had at least one eligible encounter during the first 240 days of the performance period.

Is MIPS 340 the same as MIPS 340?

Yes. CMS uses zero-padded three-digit Quality IDs (340) in official specifications, while clinicians often search for MIPS 340 or Quality ID 340 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 340: HIV Annual Retention in Care?

Submission codes: G9247 (Patient had two eligible encounters at least 90 days apart or one eligible encounter and one HIV viral load test at least 90 days apart); G9246 (Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one HIV viral load test at least 90 days apart)

How do I report MIPS Measure 340 in 2026?

MIPS Measure 340 (Quality ID 340) is reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM) via qualified registry, eCQM, or Medicare Part B claims where applicable.

Is MIPS 340 a topped-out measure?

No, MIPS 340 is not topped out, meaning there is still meaningful performance variation across clinicians.

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