The Merit-based Incentive Payment System (MIPS) continues to evolve, presenting unique challenges for Pathology and Radiology practices. With the 2025 performance year underway, it’s crucial for these specialties to understand the changes and strategize accordingly to optimize performance and avoid penalties. This FAQ addresses common concerns and offers solutions tailored for Pathology and Radiology professionals.

Q1: What are the key MIPS 2025 updates affecting Pathology and Radiology?

Several updates in 2025 impact Pathology and Radiology practices:

• Performance Threshold: Remains at 75 points.
• Data Completeness: Maintained at 75% through the 2028 performance period.
• Quality Category:
  • Removal of the 7-point cap for topped-out measures in specialty sets with limited measures, allowing scoring up to 10 points.
  • Introduction of new measures, such as QPP 494 for Radiology.
• Improvement Activities:
  • Simplified scoring by eliminating weights; all activities are now equally weighted.
  • Removal of certain activities previously utilized by these specialties.
• Cost and Promoting Interoperability (PI):
  • New episode-based Cost measures introduced, though many are unlikely to be attributed to Pathology or Radiology.
  • Non-patient-facing clinicians and small practices continue to receive automatic reweighting for Cost and PI categories.

Q2: How can Pathology practices address the limited availability of applicable quality measures?

Pathology practices often face challenges due to a limited number of relevant quality measures. To address this:

• Utilize the Pathologists Quality Registry: Offers 14 quality measures, including seven MIPS clinical quality measures (CQMs) and seven CAP-developed QCDR measures, College of American Pathologists
• Stay Informed on Measure Updates: For instance, QPP 249 (Barrett Esophagus Pathology Reporting) now includes a new denominator exception, enhancing reporting flexibility.
• Explore Alternative Measures: Consider measures like QPP 491 (Mismatch Repair or Microsatellite Instability Biomarker Testing Status) to diversify reporting options.

Q3: What strategies can Radiology practices employ to optimize their MIPS performance?

Radiology practices can enhance their MIPS performance by:

• Leveraging New and Updated Measures: Incorporate measures like QPP 494 (Excessive Radiation Dose or Inadequate Image Quality for Diagnostic CT in Adults) and the five new ACR QCDR measures introduced in 2025.
• Monitoring Measure Benchmarks: Stay updated on CMS benchmarks to understand scoring implications and adjust reporting strategies accordingly.
• Engaging in Continuous Quality Improvement: Use MIPS data to identify areas for clinical improvement and implement targeted interventions.

Q4: How does the removal of certain Improvement Activities affect these specialties?

The elimination of specific Improvement Activities necessitates adjustments:

• Identify Alternative Activities: With the removal of activities like ERP_4 (Implementation of a Personal Protective Equipment Plan), practices should explore other relevant activities that align with their operations.
• Simplified Scoring: All Improvement Activities now carry equal weight, simplifying the selection process.
• Special Status Considerations: Clinicians with special statuses (e.g., small practice, non-patient-facing) may have reduced reporting requirements, such as attesting to fewer activities.

Q5: What role do Qualified Clinical Data Registries (QCDRs) play in MIPS reporting for these specialties?

QCDRs are instrumental in MIPS reporting:

• Specialty-Specific Measures: QCDRs like the Pathologists Quality Registry and ACR’s NRDR offer measures tailored to Pathology and Radiology.
• Enhanced Reporting Flexibility: QCDRs allow for more comprehensive data submission, potentially capturing a broader scope of clinical activities.
• Performance Feedback: These registries often provide feedback reports, aiding in performance monitoring and improvement.

Q6: How can TriumpHealth assist Pathology and Radiology practices in navigating MIPS 2025?

TriumpHealth offers comprehensive support, including:

• Customized Reporting Strategies: Tailored approaches to select the most applicable measures and activities.
• Data Collection and Submission Assistance: Streamlining the reporting process to ensure accuracy and completeness.
• Performance Analysis and Improvement Plans: Identifying areas for enhancement and implementing strategies to boost MIPS scores.
• Regulatory Updates: Keeping practices informed about changes in MIPS requirements and best practices.

Need Expert Guidance on MIPS 2025?

Contact TriumpHealth today to schedule a consultation and ensure your Pathology or Radiology practice excels in MIPS reporting. For more details contact us at 888-747-3836 X0 or email us at [email protected]