Who is eligible for MIPS 374?

Number of patients, regardless of age, who had an encounter during the performance period and were referred by one clinician to another clinician on or before October 31.

Is MIPS 374 the same as MIPS 374?

Yes. CMS uses zero-padded three-digit Quality IDs (374) in official specifications, while clinicians often search for MIPS 374 or Quality ID 374 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 374: Closing the Referral Loop: Receipt of Specialist Report?

Submission codes: G9969 (Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred); G9970 (Clinician who referred the patient to another clinician did not receive a report from the clinician to whom the patient was referred)

How do I report MIPS Measure 374 in 2026?

MIPS Measure 374 (Quality ID 374) 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 374 a topped-out measure?

Yes, MIPS 374 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 374|Care Coordination|2026 Performance Year

2026 MIPS Measure #374: Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred.

Process – High PriorityCare CoordinationPatient Safety

Measure ID:MIPS 374 (Quality ID 374)

eCQM:CMS50v14

Collection:MIPS CQM, eCQM

Topped Out:Yes

View CMS Spec ↗

Measure Specification

Eligible Population

Patients regardless of age on the date of the encounter

ANDPatient encounter during the performance period

ANDPatient was referred to another clinician or specialist during the measurement period: G9968

Exclusions

None

Numerator

Number of patients with a referral on or before October 31, for which the referring clinician received a report from the clinician to whom the patient was referred.

Reporting Codes

Performance Met:

G9969Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred

Performance Not Met:

G9970Clinician who referred the patient to another clinician did not receive a report from the clinician to whom the patient was referred

VBCA Insights

Why This Measure Matters

When you refer a patient to a specialist, do you actually get the specialist's report back? This measure flags whether the referral loop closes—many referrals get lost in communication gaps, leaving primary care without key information. The simple action is ensuring your EHR captures specialist reports and alerts you when they arrive. Poor closure on referrals delays care adjustments, duplicates tests, and fragments the patient's care story. Closing the loop takes minimal effort but dramatically improves continuity.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 374 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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Specialty Measure Sets

Related Measures

Care Coordination

MIPS 024: Communication with the Physician or Other Clinician Managing On-Going Care Post-MIPS 243: Cardiac Rehabilitation Patient Referral from an Outpatient Setting MIPS 340: HIV Annual Retention in Care MIPS 356: Unplanned Hospital Readmission within 30 Days of Principal Procedure MIPS 440: Skin Cancer: Biopsy Reporting Time – Pathologist to Clinician MIPS 503: Gains in Patient Activation Measure (PAM) Scores at 12 Months

Patient Safety

MIPS 130: Documentation of Current Medications in the Medical Record MIPS 145: Radiology: Exposure Dose Indices Reported for Procedures Using Fluoroscopy MIPS 155: Falls: Plan of Care 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 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 Rationale

Problems in the outpatient referral and consultation process have been documented, including inadequate care pathways between specialty and primary care. Studies suggest that both specialists and primary care providers (PCPs) are not satisfied with current processes [1,2]. Breakdowns in referral communication lead to worse health outcomes, increased cost, and appointment delays [3,4].

A 2018 analysis of primary care referrals to specialists found that of the 103,737 referral scheduling attempts analyzed, only 36,072 (34.8%) resulted in documented complete appointments, defined by the specialty clinician providing report to the PCP after the referral visit [3]. Technological and process-based updates can improve the referral loop process and increase rates of closing the referral loop.

Ramelson et. al enhanced an EHR's Referral Manager module to meet the Controlled Risk Insurance Company’s best practice steps and the requirements of both the CMS EHR Incentive Program and the National Committee for Quality Assurance Patient-Centered Medical Home program. Following the updates, 76.8% of referrals were completed and all defined referral process steps were easier to accomplish [5].

Odisho et. al developed a referrals automation software to simplify the fax to referral process. Feedback from key stakeholder interviews noted that the software enhanced the referrals process by further streamlining and organizing the patient referral process [4].The Institute for Healthcare Improvement and the National Patient Safety Foundation reviewed the referrals process in the ambulatory care setting and found that organizational leaders, EHR vendors, regulatory agencies, clinicians, and patients all all play a role in creating a referrals system that is effective, safe, convenient, and patient-centered [1].

Clinical Recommendations

None

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.

The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure. All MIPS eligible clinicians reporting on this measure should note that all data for the reporting year is to be submitted by the deadline established by CMS, however, only first referrals made between January 1 - October 31 (the measurement period) will count towards the denominator to allow adequate time for the referring clinician to collect the consult report by the end of the performance period.

When clinicians to whom patients are referred communicate the consult report as soon as possible with the referring clinicians, it ensures that the communication loop is closed in a timely manner and that the data is included in the submission to CMS.

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