Prevention of Post-Operative Nausea and Vomiting (PONV) – Combination Therapy
Percentage of patients, aged 18 years and older, who undergo a procedure under an inhalational general anesthetic, AND who have three or more risk factors for post-operative nausea and vomiting (PONV), who receive combination therapy consisting of at least two prophylactic pharmacologic anti-emetic agents of different classes preoperatively and/or intraoperatively.
Last updated: January 15, 2026
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Estimate only — actual CMS scoring may vary based on reporting method, data completeness, and annual rule updates.
📖Clinical Rationale
Postoperative nausea and vomiting (PONV) is an important patient-centered outcome of anesthesia care. PONV is highly dis-satisfying to patients, although rarely life-threatening. A large body of scientific literature has defined risk factors for PONV; demonstrated effective prophylactic regimes based on these risk factors, and demonstrated high variability in this outcome across individual centers and providers.
Further, a number of papers have shown that performance can be assessed at the level of individual providers -- the outcome is common enough that sufficient power exists to assess variability and improvement at this level.
📝Clinical Recommendations
Practice Guidelines for Postanesthetic Care; American Society of Anesthesiologists, 2013 Anti-emetic agents should be used for the prevention and treatment of nausea and vomiting when indicated. Multiple anti-emetic agents may be used for the prevention and treatment of nausea and vomiting when indicated. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting; Society for Ambulatory Anesthesia (SAMBA), 2020 Administer prophylactic therapy with combination (≥ 2) interventions/multimodal therapy in patients at high risk for PONV.
📋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.
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