Measure 236
Controlling High Blood Pressure
DESCRIPTION:
Percentage of patients 18–85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90 mmHg) during the measurement period.
| MEASURE ID: | 236 |
|---|---|
| Type: | Intermediate Outcome |
CMS Derm Specialty Set: | No |
| High priority: | Yes |
| Topped out: | No |
| Telehealth Eligible: | Yes |
| Reporting methods: | Registry/QCDR, EHR, or Claims |
| Maximum points: | 10 |
MEASURE PURPOSE:
This measure encourages clinicians to monitor and control blood pressure in patients with essential hypertension. Adequately controlling high blood pressure reduces the risk of serious cardiovascular events including heart attack, stroke, and kidney disease, and can significantly reduce mortality risk.
Measure 236 FAQs
Q. Is this measure reportable via claims?
A. Yes.
Q. Are patient encounters conducted via telehealth allowable?
A. Yes. This measure is telehealth eligible. Patient encounters conducted via telehealth using encounter codes found in the denominator criteria are allowed. If the patient meets all denominator criteria for a telehealth encounter, it is appropriate to include them in the denominator eligible patient population.
Q. The measure says to report once per performance period. Is the performance period a year?
A. Yes. The performance period for this measure is 12 months. This measure is to be submitted a minimum of once per performance period for denominator eligible cases.
Q. How is the hypertension diagnosis timeframe defined?
A. The diagnosis of essential hypertension must be present some time between 1 year prior to the measurement period and the first six months of the measurement period (January 1, 2026 – June 30, 2026).
Q. Which blood pressure readings are acceptable for this measure?
A. Only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable. This includes readings taken in person, remotely via electronic monitoring devices capable of transmitting data to the clinician, or readings from an automated device conveyed by the patient to the clinician. Blood pressure readings taken by the patient using a non-digital device such as a manual cuff and stethoscope are not acceptable.
Q. What if there are multiple blood pressure readings on the same day?
A. If there are multiple blood pressure readings on the same date of service, use the lowest systolic and lowest diastolic blood pressure on that date as the representative blood pressure. Each value (systolic and diastolic) must be submitted separately.
Q. What if no blood pressure is recorded during the measurement period?
A. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed “not controlled” and will count as performance not met.
Q. Are blood pressure readings taken during an inpatient stay or ED visit eligible?
A. No. Do not include BP readings taken during an acute inpatient stay or an ED visit. Additionally, do not include readings taken on the same day as a diagnostic test or therapeutic procedure that requires a change in diet or medication on or one day before the test or procedure (except fasting blood tests). BP readings taken on the same day as common low-intensity or preventive procedures — such as vaccinations, injections, TB tests, IUD insertion, eye exams with dilating agents, or wart/mole removal — are eligible.
Q. If the measure is submitted more than once for the same patient, which result is used?
A. The most recent quality data code (QDC) will be used if the measure is submitted more than once for the same patient during the performance period.
Calculation
The numerator: Patients whose most recent blood pressure is adequately controlled (systolic <140 mmHg and diastolic <90 mmHg) during the measurement period.
The denominator: All patients 18–85 years of age with a diagnosis of essential hypertension (ICD-10: I10) starting before and continuing into, or starting during the first six months of the measurement period.
Measure calculation example
Dr. Patel has 210 patients with essential hypertension seen during the first 6 months of the performance period. This is the denominator.
Of those, 168 patients had their most recent blood pressure recorded below 140/90 mmHg. This is the numerator.
Quality of patient care = 168 ÷ 210 = 80.0% for this measure. This score translates to 9.0 to 9.9 points when reporting by registry.
Important note
This measure requires both a systolic and diastolic value submitted separately. Ranges and thresholds (e.g., “BP within normal limits”) do not meet the numerator criteria — a distinct numeric result for both readings is required. Reporting frequency is a minimum of once per performance period per eligible patient.
Quality measure score benchmark
CMS will award points based on a comparison of your performance rate to CMS benchmarks listed below. Reach the performance rate listed to achieve the corresponding points per measure. Points achieved for the Quality category will account for 30% of the overall MIPS score.
Benchmarks for registry submissions
The table below shows CMS benchmarks for registry submissions.
Decile 1 | Decile 2 | Decile 3 | Decile 4 | Decile 5 | Decile 6 | Decile 7 | Decile 8 | Decile 9 | Decile 10 | |
|---|---|---|---|---|---|---|---|---|---|---|
Performance rate |
1.00 - 9.99 |
10.00 - 19.99 |
20.00 - 29.99 |
30.00 - 39.99 |
40.00 - 49.99 |
50.00 - 59.99 |
60.00 - 69.99 |
70.00 - 79.99 |
80.00 - 89.99 |
>=90.00 |
Points |
1.0 - 1.9 |
2.0 - 2.9 |
3.0 - 3.9 |
4.0 - 4.9 |
5.0 - 5.9 |
6.0 - 6.9 |
7.0 - 7.9 |
8.0 - 8.9 |
9.0 - 9.9 |
10 |
Benchmarks for EHR submissions
The table below shows CMS benchmarks for EHR submissions.
| Decile 1 | Decile 2 | Decile 3 | Decile 4 | Decile 5 | Decile 6 | Decile 7 | Decile 8 | Decile 9 | Decile 10 | |
|---|---|---|---|---|---|---|---|---|---|---|
|
Performance rate |
4.76 - 45.27 |
45.28 - 55.55 |
55.56 - 61.53 |
61.54 - 65.60 |
65.61 - 68.97 |
68.98 - 71.99 |
72.00 - 74.99 |
75.00 - 78.69 |
78.70 - 84.03 |
>=84.04 |
|
Points |
1.0 - 1.9 |
2.0 - 2.9 |
3.0 - 3.9 |
4.0 - 4.9 |
5.0 - 5.9 |
6.0 - 6.9 |
7.0 - 7.9 |
8.0 - 8.9 |
9.0 - 9.9 |
10 |
Benchmarks for claims submissions
The table below shows CMS benchmarks for claims submissions.
| Decile 1 | Decile 2 | Decile 3 | Decile 4 | Decile 5 | Decile 6 | Decile 7 | Decile 8 | Decile 9 | Decile 10 | |
|---|---|---|---|---|---|---|---|---|---|---|
|
Performance rate |
1.00 - 9.99 |
10.00 - 19.99 |
20.00 - 29.99 |
30.00 - 39.99 |
40.00 - 49.99 |
50.00 - 59.99 |
60.00 - 69.99 |
70.00 - 79.99 |
80.00 - 89.99 |
>=90.00 |
|
Points |
1.0 - 1.9 |
2.0 - 2.9 |
3.0 - 3.9 |
4.0 - 4.9 |
5.0 - 5.9 |
6.0 - 6.9 |
7.0 - 7.9 |
8.0 - 8.9 |
9.0 - 9.9 |
10 |
