May 23, 2025 Release Highlights Copied

05/23/20252025 VBCRelease note

Practice Insights is pleased to announce updates in the application to support the Merit-Based Incentive Payment System (MIPS).

MIPS Quality Measures Dashboard

The MIPS Quality Measures Dashboard will be updated to reflect the below refinement(s):

Measure Description Practice Impact
MIPS 001: Hemoglobin A1c (HbA1cc) Poor Control (>9%) (Inverse Measure) Denominator Exclusion:

  • Removed two outpatient encounters for advanced illness
  • Removed advanced illness with one inpatient encounter during the measurement period or the year prior
 Minimal shift in denominator and/or numerator count
MIPS 236: Controlling High Blood Pressure Denominator Exclusion:

  • Removed two outpatient encounters for advanced illness
  • Removed advanced illness with one inpatient encounter during the measurement period or the year prior
 Minimal shift in denominator and/or numerator count
MIPS 450: Appropriate Treatment for Patients with Stage I (T1c) III Her2 Positive Breast Cancer
  • Removed female gender population and opened to all patients
  • Added patient must have a diagnosis between July 1 of the previous performance period through June 30 of the current performance period.
  • Removed HER2 drug abbreviation condition, requiring both chemotherapy and HER2-targeted therapy to occur within 6 months of pathologic staging
  • Added new ICD-10 breast cancer codes
 Shift in denominator and/or numerator count
MIPS 451: RAS (KRAS & NRAS) Testing Performed for Patients with Metastatic Colorectal Cancer who Receive Anti-EGFR Monoclonal Antibody Therapy
  • Removed telehealth modifier ‘95’ code
  • For Denominator, we are capturing Stage IV patients or patients who have distinct metastases at the time of colon cancer diagnosis
  • Capturing patients’ initial diagnosis date between December 1 of the prior year through November 30 of the performance period, and anti-EGFR monoclonal antibody therapy date between December 1 to prior year through December 31 of the previous performance period
 Significant drop in Denominator count

Please Note: Practices may drop below the 20 patient threshold
MIPS 453: Proportion Receiving Chemotherapy in the Last 14 Days of Life (Inverse Measure)
  • Added new Cancer Diagnosis ICD-10 codes
  • Removed telehealth modifier ‘95’ code
 Minimal shift in denominator and/or numerator count
MIPS 462: Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy
  • Removed male gender population and opened to all patients
  • Added timeframe for ordering of ADT in 3 months before to 9 months after the start of the measurement period
 Minimal shift in denominator and/or numerator count
MIPS 487: Screening for Social Drivers of Health
  • Removed telehealth modifier ‘95’ code
  • Added new Patient Encounter CPT codes
 Minimal shift in denominator and/or numerator count

Status of Dashboard Updates for 2025

CMS releases updates to the quality measure specifications annually for the MIPS program. These measure specifications have been reviewed, and Practice Insights is working on the required technical updates to align with the revised requirements. Ontada will continue to notify practices once measures have been updated based on the current 2025 requirements.

Measure Description
MIPS Quality Measures Dashboard
MIPS #001 Diabetes Hemoglobin A1c (HbA1cc) Poor Control (>9%) (Inverse Measure)
MIPS #047 Advance Care Plan
MIPS #130 Current Medications Documentation
MIPS #226 Tobacco Screening and Cessation
MIPS #236 Controlling High Blood Pressure
MIPS #238 Use of High-Risk Medications in Older Adults (Inverse Measure)
MIPS #374 Closing the Referral Loop
MIPS #450 Appropriate Treatment for Patients with Stage I (T1c) III Her2 Positive Breast Cancer
MIPS #451 RAS (KRAS & NRAS) Testing Performed for Patients with Metastatic Colorectal Cancer who Receive Anti-EGFR Monoclonal Antibody Therapy
MIPS #453 Proportion Receiving Chemotherapy in the Last 14 Days of Life (Inverse Measure)
MIPS #462 Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy
MIPS #487 Screening for Social Drivers of Health
PIMSH #1 Advance Care Planning in Metastatic Disease
PIMSH #13 Proportion of Stage IV nsNSCLC Patients Tested for Actionable Biomarkers and Received Mutation-Targeted Therapy
PIMSH #15 Antiemetic Therapy for Low-and Minimal-Emetic-Risk Antineoplastic Agents in the Infusion Center-Avoidance of Overuse (Inverse Measure)
PIMSH #16 Appropriate Antiemetic Therapy for High-and Moderate-Emetic-Risk Antineoplastic Agents in the Infusion Center