Measure 155: Falls: Plan of Care

This is a guide for 1.0 measure reporting. For 2.0 measure reporting, click here.

Nearly 1 in 4 older adults (65+) reported falling in the last year, causing more than 8 million injuries (according to the CDC). This makes Physical and Occupational Therapists an integral part of the public health continuum addressing the risk of falls in older adults. In this article we’ll cover when and how to document Measure 155: Falls: Plan of Care. 

Note: Previously, Measure 155 was linked to Measure 154: Falls: Risk Assessment. Measure 154 has been removed from the MIPS program for the 2022 performance year. 
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Who can report this measure?

PTs and OTs can report on this measure.

Patient Qualifications

  • Patient age (65 or older)
  • Patient has a “positive” screening for future fall risk/documentation of two or more falls within the past year or any fall with injury within the past year
  • Visit type: Initial Evaluation or Re-Evaluation

When do I report on this measure?

During each eligible visit within the performance period when a patient’s fall risk is reported as “positive” and an eligible procedure code is billed.

You must report Measure 155 any time an  Eligible Procedure Code is billed: 

  • PT: 97161, 97162, 97163, 97164
  • OT: 97165, 97166, 97167, 97168

Measure Requirements

The Plan of Care must include balance, strength, and gait training and include one of the following options:

  • Documentation that balance, strength, and gait training/instructions were provided, OR
  • Referral to an exercise program, which includes at least one of the three components: balance, strength, or gait, OR
  • Referral to physical therapy

Measure Specification

For more information on Measure 155, please see the Measure Specification Guide.

Measure Reporting in WebPT

  1. On the Objective Tab, select the Falls: Plan of Care link from Measure 155 in the MIPS Measure Tests section.                                                 
  2. Falls: Plan of Care will appear in the Special Tests section. Select the Yes radio button to reveal the additional options.
  3. Select Yes for all of the following radio buttons: Gait Training and Balance/Strength. You must complete each field to meet the measure requirements.
  4. When finished documenting, validate the selection in the MIPS tab.

MIPS Tab: Reporting Selections

In the MIPS tab, the system will automatically select the measure that best fits your documentation. Below, we’ve indicated which selections do not meet the measure specifications.

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