AQI 48 · Patient-Reported Experience with Anesthesia

Steward: American Society of Anesthesiologists / Anesthesia Quality Institute | First Performance Year: 2017 2026 Status: Approved by CMS for the 2026 MIPS performance period. Available in the Anesthesia MVP.

MEASURE DESCRIPTION

Percentage of patients aged 18 and older who were surveyed on their patient experience and satisfaction with anesthesia care and who reported a positive experience.

This measure consists of two performance rates:

AQI 48a: Percentage of patients aged 18 and older who were surveyed on their patient experience and satisfaction with anesthesia care.

AQI 48b: Percentage of patients aged 18 and older who completed a survey on their patient experience and satisfaction with anesthesia care and who report a positive experience within 60 days of receipt of the survey.

NOTE: A valid survey, as defined in the numerator of AQI 48a, must be sent to patients between discharge from the facility and within 30 days of facility discharge. To report AQI 48b, a minimum of 20 surveys with the mandatory question completed must be reported. To be scored on this measure, clinicians must report BOTH AQI 48a AND AQI 48b.

NQS DOMAIN / MEANINGFUL MEASURES AREA

Person and Caregiver-Centered Experience and Outcomes / Patient's Experience of Care

MEASURE TYPE: Patient-Reported Outcome-based Performance Measure (PRO-PM) HIGH PRIORITY STATUS: Yes | HIGH PRIORITY TYPE: Outcome INVERSE MEASURE: No | RISK ADJUSTED: No NUMBER OF PERFORMANCE RATES: 2 OVERALL PERFORMANCE RATE FOR SCORING: AQI 48b CARE SETTING: Ambulatory Care (Clinician Office/Clinic), Ambulatory Care (Hospital), Hospital, Hospital Inpatient, Outpatient Services TELEHEALTH: No DATA SOURCE: Claims, EHR, hybrid, registry, survey REPORTING OPTIONS: MVP and Traditional MIPS

2026 BENCHMARK

National average performance rate: 94.73%. Historical benchmark. Not topped out. Not capped.

Reading this benchmark: the entire scoring range spans about 14 points, and deciles 4 through 8 are separated by roughly half a point each. This measure rewards a genuinely good patient experience program and punishes a mediocre one sharply. It is also one of the few measures in our set where the top decile is achievable without perfection, since Decile 10 begins at 97.78% rather than 100%.

Operational note: the 20-survey minimum and the 60-day response window are the two most common failure points. Groups that send surveys but do not chase responses often clear AQI 48a and then fail to reach 20 completed surveys for AQI 48b, which zeroes the measure since 48b is the scored rate.

INSTRUCTIONS

AQI 48a should be reported each time a patient undergoes a procedure under anesthesia. AQI 48b should be reported every time a completed survey is returned by the patient within 60 days of receipt. To be scored on AQI 48b, the provider must collect the individual scores received on the survey as described in AQI 48a.

Measure reporting via the QCDR: CPT codes and patient demographics identify patients in the denominator. Registry codes report the numerator.

AQI 48a

DESCRIPTION

Percentage of patients aged 18 and older who were surveyed on their patient experience and satisfaction with anesthesia care.

DENOMINATOR

Patients aged 18 and older who undergo a procedure* under anesthesia.

Definition: *Any procedure including surgical, therapeutic, or diagnostic.

Denominator Criteria (Eligible Cases): - Patient aged 18 years or older on date of encounter - AND Patient encounter during the reporting period matching the measure's CPT list. This is the broadest code list in our set: 376 codes spanning the full ASA anesthesia range plus pain management, injection, catheter, and neurostimulator codes. The full list appears at the end of this measure.

DENOMINATOR EXCLUSIONS

- Organ donors as designated by ASA Physical Status 6 - Patient died within 30 days of the procedure (10A11)

NUMERATOR

Patients who received a survey within 30 days of the procedure to assess their experience and satisfaction with anesthesia.

Numerator Note: The survey should be administered shortly following discharge from the facility.

Definition of a valid survey: Practices and eligible clinicians may customize their surveys to meet local needs, but at a minimum a valid survey must include a core set of questions addressing three of the four following criteria, plus one mandatory question:

1. Preoperative education and preparation
2. Patient and/or family communication
3. Care team response to comfort and well-being
4. Postoperative pain control and/or management

Mandatory question (practices must also include a "Not Applicable" option):

On a scale of 1 to 5, where 1 indicates the worst anesthesia experience and 5 indicates the best anesthesia experience, how would you rate your anesthesia experience?

Numerator Note: Practices may wish to supplement these questions using the ASA Committee on Performance and Outcomes Measurement work product "Patient Satisfaction with Anesthesia White Paper," and the five-component Perioperative Surgical Home framework: preoperative education and preparation; check-in and pre-procedure experience; caregiver and family communication during surgery; care team response to comfort and well-being; and postoperative pain management. See https://www.asahq.org/psh.

Numerator Quality-Data Coding Options:

Performance Met: 10A12 Patient provided with a survey within 30 days of the procedure

OR

Denominator Exception: 10A13 Documentation of patient, process, or medical reasons for not receiving a survey. This covers patients who are non-verbal, unable to be surveyed for a medical or psychiatric reason, unable to be surveyed due to a language barrier, who have not provided contact information, who are discharged to assisted living, a skilled nursing facility, or a similar location where direct access is unavailable, or who decline to be surveyed.

OR

Performance Not Met: 10A14 Patient was not provided with a survey within 30 days of the procedure

OR

11A93

The patient did not respond within 60 days of receipt of the survey.

Important: 11A93 exists to remove unreturned surveys from the calculation. Reporting it is essential for the data completeness calculation and does NOT indicate negative performance. Performance is calculated on AQI 48b. Groups that omit this code damage their data completeness for no reason.

AQI 48b

DESCRIPTION

Percentage of patients who complete the survey from AQI 48a and report a positive experience within 60 days of receipt of the survey.

DENOMINATOR

All patients from the numerator of AQI 48a who complete a survey on their patient experience and satisfaction with anesthesia care within 60 days of receipt of the survey.

DENOMINATOR NOTE: The denominator must include a minimum of 20 returned surveys.

Denominator Criteria (Eligible Cases): - Patient completed a survey on their patient experience and satisfaction with anesthesia care within 60 days of receipt (11A94)

DENOMINATOR EXCLUSIONS

- Patient did not complete the mandatory anesthesia satisfaction question within 60 days of receipt of the survey (11A95)

NUMERATOR

Patients who reported a positive experience with anesthesia care.

Definition: A positive experience is a response of 4 or 5 on the mandatory survey question.

Reporting note: To report this measure, the provider must submit the individual patient scores. The percentage reporting a positive experience is calculated on the provider's behalf.

Numerator Quality-Data Coding Options:

Performance Met: 10A70 Patient reported a positive anesthesia experience (a 4 or 5 on the mandatory survey question)

OR

Performance Not Met: 10A71 Patient did NOT report a positive anesthesia experience (a 1, 2, or 3 on the mandatory survey question)

RATIONALE

Despite the implementation of CAHPS and H-CAHPS, there remains a persistent gap in the ability to adequately measure patient experience for performance-based payment programs. To provide high quality, patient-centered care, anesthesiologists and other qualified anesthesia providers should measure and respond to patients' perception of the degree to which they felt treated as individuals and empowered to engage in decision-making about their care. Assessment of patient satisfaction with anesthesia care provides feedback that enables providers to improve care delivery and quality. A wide array of tools is available for practices to implement based on local patient populations and quality improvement initiatives.

RELEVANT FIELDS (Graphium capture)

- Date of procedure - Date of birth - ASA CPT code - ASA physical status - Survey sent, and date sent - Survey received, and date received - Response to mandatory question (1 to 5, or Not Applicable) - Reason for not surveying, if applicable

REPORTING CODES

CHANGES FOR 2026

The AQI 48b denominator and exclusion codes changed. The denominator code is now 11A94 (previously 10A72) and the exclusion is now 11A95 (previously 10A69). The 60-day response window is now stated explicitly in both.

DENOMINATOR CPT CODES

A case must carry one of the codes below to enter this measure's denominator. The other denominator criteria above still apply - a matching code makes a case eligible for consideration, not automatically countable.

AQI 48a

Procedure codes (110). AQI 48 uses one combined eligible CPT list. A qualifying code may come from this group or the anesthesia-code group below; one from each group is not required. All other denominator criteria still apply:

Anesthesia codes (266):

Codes apply to AQI 48a. AQI 48b's denominator is drawn from the AQI 48a numerator and has no separate code list.

Source: 2026 AQI NACOR QCDR Measure Book. CPT copyright American Medical Association.