CMS has released the 2025 Physician Fee Schedule Final Rule with significant changes to the MIPS program for specialty practices with limited point and measure options, responding to feedback about the difficulty of reaching the 75-point threshold for a neutral payment adjustment.
Previously, most pathology and radiology measures were capped at 7 points, making it hard for these practices to reach the 75-point threshold. For 2025, the 7-point cap has been removed, and the measures are again worth up to 10 points, with 97% performance or higher earning at least 7.5 points.
Pathology and Radiology measures affected by this update are:
Pathology
249 - Barrett’s Esophagus
250 - Radical Prostatectomy Pathology Reporting
395 - Lung Cancer Reporting (Biopsy/Cytology Specimens)
396 - Lung Cancer Reporting (Resection Specimens)
397 - Melanoma Reporting
440 - Skin Cancer: Biopsy Reporting Time – Pathologist to Clinician
Radiology
360 - Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose Radiation Imaging Studies: Computed Tomography (CT) and Cardiac Nuclear Medical Studies
364 - Optimized Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines
405 - Appropriate Follow-up Imaging for Incidental Abdominal Lesions
406 - Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients
436 - Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
We expect this change to make MIPS program participation easier on our clients. APS will provide practice-specific detail in early 2025 once the measures and point system are finalized.
