Measure ID: MIPS 485|Dermatology|2026 Performance Year

2026 MIPS Measure #485: 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.

Patient-Reported Outcome-based Performance Measure – High PriorityDermatologyPatient-Reported Outcomes
Measure ID:MIPS 485 (Quality ID 485)
Collection:MIPS CQM
Topped Out:No
View CMS Spec ↗

Measure Specification

Eligible Population
Patients aged ≥ 8 years on the date of the encounter
ANDDiagnosis of psoriasis on the date of the encounter
ANDAt least two patient encounters during the performance period
ANDInitial (index visit) Numeric Rating Scale (NRS), Visual Rating Scale (VRS), or ItchyQuant assessment score of greater than or equal to 4: M1196
Exclusions

None

Numerator
Patients who achieve an assessment score that is reduced by 3 or more points (minimal clinically important difference) from the initial (index) assessment score.
Reporting Codes

Performance Met:

M1197Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score

Performance Not Met:

M1198Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter
VBCA Insights

Why This Measure Matters

For psoriasis patients with moderate to severe itching, this measure tracks whether you assess itch severity at baseline and again at follow-up, and whether patients achieve meaningful improvement. Since over 70 percent of psoriasis patients suffer from itch that significantly impacts quality of life, reducing pruritus is a core treatment goal. Use a standardized itch scale at visits, adjust therapies (topical, systemic, or biologic) based on response, and document the patient's progress. Even small improvements in itch can dramatically improve patient functioning and satisfaction.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 485 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM) or through qualified registry submission.

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Specialty Measure Sets

Dermatology

Related Measures

Patient-Reported Outcomes
MIPS 191: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract SurgeryMIPS 217: Functional Status Change for Patients with Knee ImpairmentsMIPS 218: Functional Status Change for Patients with Hip ImpairmentsMIPS 219: Functional Status Change for Patients with Lower Leg, Foot or Ankle ImpairmentsMIPS 220: Functional Status Change for Patients with Low Back ImpairmentsMIPS 221: Functional Status Change for Patients with Shoulder ImpairmentsMIPS 222: Functional Status Change for Patients with Elbow, Wrist or Hand ImpairmentsMIPS 303: Cataracts: Improvement in Patient’s Visual Function within 90 Days Following CataractMIPS 420: Varicose Vein Treatment with Saphenous Ablation: Outcome SurveyMIPS 459: Back Pain After Lumbar SurgeryMIPS 461: Leg Pain After Lumbar SurgeryMIPS 470: Functional Status After Primary Total Knee ReplacementMIPS 471: Functional Status After Lumbar SurgeryMIPS 478: Functional Status Change for Patients with Neck ImpairmentsMIPS 483: Person-Centered Primary Care Measure Patient Reported OutcomeMIPS 486: Dermatitis – Improvement in Patient-Reported Itch SeverityMIPS 505: Reduction in Suicidal Ideation or Behavior Symptoms

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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