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  • MIPS 2023—PI: The E-Prescribing Objective

    This content is excerpted from EyeNet’s MIPS 2023: A Primer and Reference; also see the Academy’s MIPS hub page.

    This objective involves reporting—or claiming the exclusions for—two measures: the e-Prescribing measure and the Query of Prescription Drug Monitoring Program (PDMP) measure.

    e-Prescribing measure. Either report your performance rate or claim an exclusion for this measure. If you perform this measure, which involves transmitting prescriptions using your CEHRT, you will be scored based on your performance rate.

    Exclusion for e-Prescribing measure. You can claim an exclusion from this measure if you write “fewer than 100 permissible prescriptions during the performance period.” If you claim this exclusion, the points associated with this measure will be redistributed to the Health Information Exchange objective.

    Query of Prescription Drug Monitoring Program (PDMP) measure. In 2022, this was an optional bonus measure that focused on Schedule II opioids. This year, the measure has been expanded to include Schedule III and IV drugs and you must either attest that you met its requirements or report an exclusion. The measure’s expanded description is as follows: “For at least one Schedule II opioid or Schedule III or IV drug electronically prescribed using CEHRT during the performance period, the MIPS eligible clinician uses data from CEHRT to conduct a query of a PDMP for prescription drug history.”

    What are PDMPs? PDMPs are electronic databases that track prescriptions for controlled substances. CMS says that there is a PDMP in each state.

    What are Schedule II, III, and IV drugs? Unlike Schedule I substances (such as heroin), Schedule II, III, and IV substances all have accepted medical uses but are open to abuse.

    Schedule II drugs have a high potential for abuse. Such abuse can lead to moderate or low physical dependence or high psychological dependence. According to CMS, examples include “Hydrocodone, methadone, Demerol, OxyContin, Percocet, morphine, codeine, and amphetamine.” Compared with Schedule II drugs, there is less potential for abuse with Schedule III and IV drugs.

    Examples of Schedule III drugs include, “Tylenol with codeine and anabolic steroids.”

    Examples of Schedule IV drugs include “Xanax, Klonopin, Valium, and Ativan.”

    Exclusions for Query of PDMP measure. You can claim an exclusion from the Query of PDMP measure in the following circumstances: 1) if you write fewer than 100 permissible prescriptions during the performance period and/or 2) if you are unable to prescribe Schedule II, III, and IV drugs in accordance with applicable law and/or—for 2023 only—3) if querying a PDMP “would impose an excessive workflow or cost burden” prior to the start of your PI performance period. If you claim one of these exclusions, CMS will reassign the points associated with this measure to the e-Prescribing measure.

    Previous: PI: Your EHR System Must Be a CEHRT
    Next: PI: The Health Information Exchange (HIE) Objective 

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