2016 PQRS Measure #226: Preventive Care and Screening: Tobacco Use


Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user


This measure is to be reported once per reporting period for patients seen during the reporting period. This measure is intended to reflect the quality of services provided for preventive screening for tobacco use.


All patients aged 18 years and older

Patient encounter during the reporting period (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90845, 92002, 92004, 92012, 92014, 92521, 92522, 92523, 92524, 92540, 92557, 92625, 96150, 96151, 96152, 97003, 97004, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99406, 99407, G0438, G0439


Patients who were screened for tobacco use at least once within 24 months AND who received tobacco cessation counseling intervention if identified as a tobacco user

Tobacco Use – Includes use of any type of tobacco.
Tobacco Cessation Intervention – Includes brief counseling (3 minutes or less), and/or pharmacotherapy.

NUMERATOR NOTE: In the event that a patient is screened for tobacco use and identified as a user but did not receive tobacco cessation intervention report 4004F with 8P.

Numerator Quality-Data Coding Options for Reporting Satisfactorily:
Patient Screened for Tobacco Use, Identified as a User and Received Intervention
Performance Met: CPT II 4004F: Patient screened for tobacco use AND received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user
Patient Screened for Tobacco Use and Identified as a Non-User of Tobacco
Performance Met: CPT II 1036F: Current tobacco non-user


Tobacco Screening not Performed for Medical Reasons
Append a modifier (1P) to CPT Category II code 4004F to report documented circumstances that appropriately exclude patients from the denominator
Medical Performance Exclusion: 4004F with 1P: Documentation of medical reason(s) for not screening for tobacco use (eg, limited life expectancy, other medical reasons)


Tobacco Screening OR Tobacco Cessation Intervention not Performed, Reason Not Otherwise
Append a reporting modifier (8P) to CPT Category II code 4004F to report circumstances when the action described in the numerator is not performed and the reason is not otherwise specified.
Performance Not Met: 4004F with 8P: Tobacco screening OR tobacco cessation intervention not performed, reason not otherwise specified

I want to compliment you and your colleagues for fine work.

Practice Administrator, Internal Medicine, Saint Augustine, FL

I've looked at all of them now and I'm convinced that yours is the best registry. So professional, so simple to use and backed by knowledgeable, personal support. I'm confident that I'll get PQRS reporting right!

Private Group Practice, Colorado

This is an intuitive interface that gathers just the info you need and nothing more. Whoever put it together had a good understanding of the info needed and how to set it up logically.

Physician, General Practice Network, Greensboro, NC

I recommended this solution to my colleagues and they're signing up too!

Physician Assistant, Family Care Group Practices, Chicago, IL

FYI, we did get a nice check from CMS (over $20,000!) so it is well worthwhile.

University of Pennsylvania

"I didn't know that I could have it any better. Somebody needs to let others know about all of the benefits of PQRSPRO!"

RN/Coder, Private Cardiology Practice

About 80% of our patient populate are Medicare, so CMS PQRS program incentives have been very lucrative for us.

RN/Coder, Private Cardiology Practice

We used a popular, more expensive PQRS Registry last year and had issues with the website but could not get anyone on the phone and had to leave voicemail and follow-up with an email.  For the money that we paid, they should have better customer service. PQRSPRO customer service is a Rolls Royce compared to the Volkswagen I experienced last year. When I called, I spoke to someone right away!

RN/Coder, Private Cardiology Practice

The PQRSPRO Registry system was easier to use than the other one.  Chart abstraction was simple and easy to understand and all measure questions were asked at once.  The other system made me wait for a prompt to move on once I answered one question – a much slower process.

RN/Coder, Private Cardiology Practice

The cost of PQRSPRO is much more reasonable than any other!

RN/Coder, Private Cardiology Practice

The final measure report was great and will also be useful for submitting to our malpractice insurance carrier to qualify for a discounted premium rate.

RN/Coder, Private Cardiology Practice

Users reported receiving up to $70,000 from participation in 2010 via our system.

President, Healthmonix

We are very happy with you and your company. Thank you for all of you efforts.

After trying for a couple years to receive the bonus, we finally received it this year using your system.

Your support has been awesome!

I wish we would've known about you three years ago! This was a breeze!

Group Cardiology Practice, Illinois

We are very satisfied with your process and service and confident that our practice will benefit from the incentive and avoid the penalties.

Intern, Ophthalmology Practice

Measure #226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS Disclaimer

If reporting for Physician Quality Reporting System (PQRS) through another Centers for Medicare and Medicaid Services’ (CMS) program (such as the Medicare Shared Savings Program, Comprehensive Primary Care Initiative, Pioneer Accountable Care Organizations), please check the program’s requirements for information on how to report quality data to earn a PQRS incentive and/or avoid the PQRS payment adjustment.

Please note, although CMS has attempted to align or adopt similar reporting requirements across programs, eligible professionals (EPs) should look to the respective quality program to ensure they satisfy the PQRS, Electronic Health Record (EHR) Incentive Program, Value-based Payment Modifier (VM), etc. requirements of each of these programs.

You should not select that you participate in the Medicare PQRS-EHR Incentive Pilot when you attest to this question on the CMS website. The Healthmonix Registry is NOT a qualified submission vendor for clinical quality measures for purposes of meaningful use.