MIPS # 374 Closing the Referral Loop
2026 measure specification coding updates pending in Practice Insights.
MEASURE DESCRIPTION
Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred
Relevance to Value Based Care
Information exchange between providers, for time-limited referrals or consultations, on-going co-management, or during care transitions facilitates the coordination of care.
Care coordination improves quality of care for patients, reduces hospitalizations, and improves adherence to evidence-based care guidelines.
The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure.
Numerator
Number of patients with a referral on or before October 31, for which the referring clinician received a report from the first clinician to whom the patient was referred.
A procedural report received from a specialist for an exam or procedure conducted (e.g., diabetic eye exam, colonoscopy, etc.) can satisfy the numerator requirement and successfully close the referral loop. A separate consultant note or consultant report is not required to close the referral loop in these circumstances.
Denominator
Number of patients, regardless of age, who had an encounter during the measurement period & referred by one clinician to another clinician on or before October 31st
Exclusion/Exceptions
None.
Scoring Up to 10 points
RESOURCES
2025 CMS eCQM Specifications for Closing the Referral Loop Link
