Who is eligible for MIPS 413?

All patients with cerebrovascular accident (CVA) undergoing endovascular stroke treatment.

Is MIPS 413 the same as MIPS 413?

Yes. CMS uses zero-padded three-digit Quality IDs (413) in official specifications, while clinicians often search for MIPS 413 or Quality ID 413 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 413: Door to Puncture Time for Endovascular Stroke Treatment?

Submission codes: G9580 (Door to puncture time of 90 minutes or less); G9582 (Door to puncture time of greater than 90 minutes, no reason given)

How do I report MIPS Measure 413 in 2026?

MIPS Measure 413 (Quality ID 413) 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 413 a topped-out measure?

No, MIPS 413 is not topped out, meaning there is still meaningful performance variation across clinicians.

Measure ID: MIPS 413|Stroke|2026 Performance Year

2026 MIPS Measure #413: Door to Puncture Time for Endovascular Stroke Treatment

Percentage of patients undergoing endovascular stroke treatment who have a door to puncture time of 90 minutes or less.

Intermediate Outcome – High PriorityStrokePatient Safety

Measure ID:MIPS 413 (Quality ID 413)

Collection:MIPS CQM

Topped Out:No

View CMS Spec ↗

Measure Specification

Eligible Population

All patients, regardless of age

ANDDiagnosis for ischemic stroke

ANDPatient procedure during the performance period

Exclusions

G9766Patients who are transferred from one institution to another with a known diagnosis of CVA for endovascular stroke treatment

G9767Hospitalized patients with newly diagnosed CVA considered for endovascular stroke treatment

M1381Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure

Numerator

Patients with CVA undergoing endovascular stroke treatment who have a door to puncture time of less than 90 minutes.

Reporting Codes

Performance Met:

G9580Door to puncture time of 90 minutes or less

Performance Not Met:

G9582Door to puncture time of greater than 90 minutes, no reason given

VBCA Insights

Why This Measure Matters

For acute ischemic stroke patients receiving endovascular thrombectomy, time is brain—door-to-puncture time (arrival to catheter insertion) should be ≤90 minutes. Every minute counts for salvaging brain tissue. This measure reflects institutional efficiency: rapid CT/MRI, quick neuroendovascular team activation, streamlined workflows, and coordination between emergency and interventional teams. Meeting this benchmark requires culture change and systems thinking; achieving it meaningfully improves stroke recovery.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 413 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.

Specialty Measure Sets

Interventional Radiology Neurosurgical

Related Measures

Stroke

MIPS 187: Stroke and Stroke Rehabilitation: Thrombolytic Therapy

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 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 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

Acknowledgment of the critical importance of time to reperfusion for obtaining favorable outcomes in myocardial revascularization has led to the formation of similar initiatives as a measure of effective systems to enable an endovascular treatment program for acute stroke. Multiple hospital systems must interact effectively to enable patients presenting from any location to be assessed clinically and undergo imaging to ascertain if they are candidates for endovascular therapies.

By ensuring a door to puncture time of 90 minutes or less, stroke patients are given the best chance of functional recovery.

Clinical Recommendations

This measure is supported by the multispecialty guidelines for intra-arterial catheter directed stroke treatment published in 2013 and updated in 2018 (1, 2, 3).

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 procedure measure is submitted each time a procedure is performed during the performance period.

Report this measure through VBCA

Our QCDR handles measure selection, data validation, and submission—so you can focus on clinical performance.

Learn About Our QCDR →Talk to Us