2019 MIPS Measure #474: Zoster (Shingles) Vaccination

Measure Type High Priority Measure? Collection Type(s)
Process no MIPS CQM

Measure Description

The percentage of patients aged 50 years and older who have had a Varicella Zoster (shingles) vaccination.





NOTE: This measure is appropriate for use in ambulatory/office-based settings. For each of these settings, there should be documentation in the medical record(s) that the Shingrix zoster vaccination was ever administered.

Measure Submission Type:



All patients aged 50 years and older

Denominator Criteria (Eligible Cases):

Patients aged 50 years and older on date of encounter


Patient encounter during the performance period (CPT or HCPCS): 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99324,99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99495, 99496, G0402, G0438, G0439


Telehealth Modifier: GQ, GT, 95, POS 02



Patient pregnancy: M1061


Patient immunocompromised: M1062


Patients receiving high doses of immunosuppressive therapy: M1063


Patients who have had a full course of the Shingrix zoster (shingles) vaccination ever documented in the medical record

NUMERATOR NOTE: The numerator is determined by examining immunization data recorded in the electronic health record, either in the immunization record, the procedures list of immunization administration/injection, and in the medication record of the vaccine. The quality action for this measure is not limited to the performance period since this vaccination may occur once within a patient’s lifetime. It is appropriate to review the patient medical history to determine if this vaccination was administered.

Vaccinations administered on the denominator eligible encounter would also meet performance.

In order to meet performance for this measure, Shingrix must be administered according to the clinical guidelines which consists of 2 documented doses, administered intramuscularly, 2-6 months apart. If the clinician assesses the patient in October thru December of the current measurement year and is unable to administer 2 doses, then it would be appropriate to submit the denominator exception M1065.

Numerator Options:

Performance Met: Shingrix vaccine documented as administered or previously received (M1064)


Denominator Exception: Shingrix vaccine was not administered for reasons documented by clinician (e.g. patient administered vaccine other than Shingrix, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) (M1065)


Performance Not Met: Shingrix vaccine not documented as administered, reason not given (M1066)


CMS-Family-Medicine-2019, CMS-Geriatrics-2019, CMS-Infectious-Disease-2019, CMS-Internal-Medicine-2019, CMS-Nephrology-2019, CMS-Oncology-2019, CMS-Preventive-Medicine-2019, CMS-Skilled-Nursing-Facility-2019, ENT/Otolaryngology, General Oncology, General Practice/Family Medicine, Geriatrics / Gerontology, Hematology-Oncology, Infectious Disease, Internal Medicine, Nephrology, Orthopedics, Physical Medicine, Preventive Medicine, Quality-2019