Psoriasis – Improvement in Patient-Reported Itch Severity
The percentage of patients aged 8 years and older, with a diagnosis of psoriasis where at an initial (index) visit have a patient-reported itch severity assessment performed, score greater than or equal to 4, and who achieve a score reduction of 3 or more points at a follow-up visit.
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
Psoriasis is a chronic inflammatory disease in which pruritus is a frequent symptom. Approximately 7.4 million people in the United States have psoriasis. Direct costs of the disease are estimated between $51.7 and $63.2 billion, with the total economic burden estimated to be between $112 and $135 billion. Chronic inflammatory skin diseases, such as psoriasis, are pruritic and tremendously burdensome; with more than 70 percent of psoriasis patients suffering from itch.
Itch has profound effects on patients, especially in geriatric populations, where there is increased incidence of pruritus. For those over 65 years old, itch is the most common skin complaint. The number of patients with pruritus is expected to increase as the elderly population grows – becoming 25 percent of the US population by 2025. Pruritus is a frequent and onerous symptom of psoriasis and, on its own, has significant effects on patients’ quality of life.
In a study, investigators quantified pruritic burden in a cross-sectional analysis investigating chronic pruritus and pain. They demonstrated that the quality of life impact was due to the severity of the symptom, rather than whether the symptom was pain or pruritus. Moreover, they elucidated a mean health utility score of 0.87 from chronic pruritus (CP) patients, meaning that on average, a patient would give up 13 percent of their life expectancy to live without pruritus.
📝Clinical Recommendations
Evidence-based guideline: Joint AAD - NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures. Recommendation: Pruritus is a significant symptom of psoriasis. An itch severity assessment is recommended to appropriately assess the degree of pruritus when present.
This measure enhances compliance of the guideline by routinely assessing pruritus in psoriasis patients. For patients with moderate and severe pruritus symptoms, the measure looks to reduce pruritus burden by a minimal clinically important difference (3 or more points). Evidence-based literature: The experience of itch in children with psoriasis: A qualitative exploration of the Itch Numeric Rating Scale (Mannix, 2021) and Tools to study the severity of itch in 8- to 17-year-old children: Validation of TweenItchyQoL and ItchyQuant (Kong, 2021).
Both the NRS and ItchyQuant are validated severity tools for pediatric patients aged 8 and older. This measure assesses pruritus in both pediatric and adult populations.
📋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 visit measure is submitted each time a patient has a denominator eligible encounter during the performance period.
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