Thank you for your inquiry regarding CMS146v12 (2024 Performance Period). According to the measure steward, the National Committee for Quality Assurance (NCQA), as noted in JIRA case CQM-7022 , once value sets are published, they cannot be revised. Any updates, such as additions, deprecation, or code retirements, must be made during the subsequent value set maintenance cycle. The publication policies and timelines for the MIPS program are determined by the Centers for Medicare & Medicaid Services (CMS). Please note that we have added "Acute Pharyngitis" (2.16.840.1.113883.3.464.1003.102.12.1011) and "Acute Tonsillitis" (2.16.840.1.113883.3.464.1003.102.12.1012) as competing conditions in the most recent publication of CMS154 for performance year 2025. However, these conditions will not be included in the "Competing Conditions for Respiratory Conditions" value set (2.16.840.1.113883.3.464.1003.102.12.1017); instead, they will be part of the Competing Conditions definition for CMS154v13. Therefore, this change will not create that contradiction in CMS146v13. Again, we apologize for the inconvenience this may have caused.

The problem is, since both measures share a value set, that mapping will also impact the exclusion crtiera for CMS146v12 Appropriate testing for pharyngitis and the very diagnosis code that is bringing the patient into the denominator is now the same diagnosis that will exclude the patient. This is leading to a LARGE number of exclusions