2025 Pathology Quality Measures

The Pathologists Quality Registry offers 14 quality measures. Seven are Merit-based Incentive Payment System (MIPS) clinical quality measures (CQMs). The remaining seven are pathology measures developed by the CAP and approved by the CMS as qualified clinical data registry (QCDR) measures—exclusively available in the Pathologists Quality Registry. To better understand how to review and interpret measure specifications, the CMS has developed Quality Payment Program Measure Specification and Measure Flow Guide for MIPS Clinical Quality Measures.

Important 2025 Updates

QPP249: Barrett Esophagus Pathology Reporting – ‘Specimen site other than anatomic location of esophagus: G8797’ is now a Denominator Exception in 2025.

QPP491: Mismatch Repair (MMR) or Microsatellite Instability (MSI) Biomarker Testing Status – Measure Title updated, no other changes to measure specifications.

CAP28: Gastritis Timely Helicobacter pylori Status Reporting is no longer available in the program.

CAP 30: Urinary Bladder Cancer Complete Analysis and Timely Reporting – Addition of Denominator Exclusion, Cystectomy Surgical Procedure (ICD-10 Z90.6).

CAP34: Molecular Assessment Biomarkers Non-Small Cell Lung Cancer –Denominator Statement amended to include cytology specimens.

CAP40: Squamous Cell Skin Cancer Complete Reporting –Information added to clarify guidelines and measure interpretation. ‘Fragmentation’ removed from Denominator Exceptions.

CAP41: Basal Cell Skin Cancer Complete Reporting – Information added to clarify guidelines and measure interpretation. ‘Biopsy or Cytology specimens’ added to Denominator Exceptions. ‘Fragmentation’ removed from Denominator Exceptions.

CAP42: Barrett’s Esophagus Complete Analysis with Appropriate Consultation –Denominator expanded to all cases of Barrett’s Esophagus

  • A pathologist cannot report QPP 249: Barrett Esophagus Pathology Reporting if reporting CAP 42.

Pathology Specific QPP Measures

These measures can be reported to the CMS using the Pathologists Quality Registry, through billing/claims, and other registries.

QPP 249: Barrett Esophagus Pathology Reporting Registry and Claims Specifications; FAQs
QPP 250: Radical Prostatectomy Pathology Reporting Registry and Claims Specifications; FAQs
QPP 395: Lung Cancer Reporting (biopsy/cytology specimens) Registry and Claims Specifications; FAQs
QPP 396: Lung Cancer Reporting (resection specimens) Registry and Claims Specifications; FAQs
QPP 397: Melanoma Reporting Registry and Claims Specifications; FAQs

These measures can be reported to the CMS using the Pathologists Quality Registry and other registries.

QPP 440: Skin Cancer: Biopsy Reporting Time - Pathologist to Clinician Registry Specifications (American Academy of Dermatology measure); FAQs
QPP 491: Mismatch Repair (MMR) or Microsatellite Instability (MSI) Biomarker Testing Status in Colorectal Carcinoma, Endometrial, Gastroesophageal, or Small Bowel Carcinoma Registry Specifications; FAQs

In 2023, QPP 491, a new measure in the pathology measure set, was eligible for a performance year benchmark. View the Performance Year 2023 Benchmark for QPP 491. Please note that this 2023 benchmark does not carry over to 2024. A new performance year benchmark will be created for this measure for 2024 and will be available later in 2025.

Scores for the QPP measures depend on the benchmarks CMS sets for each measure. Estimate your score by viewing the QPP Measure Benchmarks.

Pathologists Quality Registry QCDR Measures

These measures can be reported to the CMS only with the Pathologists Quality Registry.

CAP22: Biopsy Reporting Time to Clinician
CAP30: Urinary Bladder Cancer Complete Analysis and Timely Reporting
CAP34: Molecular Assessment Biomarkers Non-Small Cell Lung Cancer
CAP38: Prostate Cancer Reporting Complete Analysis
CAP 40: Squamous Cell Skin Cancer Complete Reporting; FAQs
CAP 41: Basal Cell Skin Cancer Complete Reporting; FAQs
CAP 42: Barrett’s Esophagus Complete Analysis with Appropriate Consultation; FAQs

For 2024, four QCDR measures have historical benchmarks. Estimate your score by viewing the QCDR Measure Benchmarks.

The CMS recommends that eligible professionals check with the QPP HelpDesk for more information on measures and the QPP.

Professionals may contact the QPP Help Desk.
7:00 AM–7:00 PM CT Monday - Friday
Email: QPP@cms.hhs.gov
Phone: 866-288-8292

Suggest New Quality Measures

The CAP wants to know what matters to pathologists for quality measures. Submit your ideas for measure concepts today! Access the measure concept intake form or contact measures@cap.org for more information about nominating a concept.

Claims-Based Reporting Information

The CAP developed an instruction sheet on claims-based reporting to assist with submitting data on quality measures for MIPS through claims. The corresponding document provides the CPT II and quality data codes (QDC) and descriptors for the 2024 QPP measures.

For the 2025 Reporting Period

Pathologists in a group of 16 or more clinicians cannot submit quality measures using claims regardless of whether participating as an individual or a group.

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