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Pathology Quality Measures

Through the development of quality measures by the CAP, pathologists avoid Medicare payment penalties and earn bonuses when reported correctly. In 2016, for example, pathologists faced a combined $30.9 million in penalties from Medicare's quality programs if measures were not successfully reported. Previously, pathologists also earned $25 million in Medicare bonuses after reporting quality measures developed by the CAP and its Council on Government and Professional Affairs.

The Pathologists Quality Registry offers 17 quality reporting measures all developed by the CAP. Eight are Quality Payment Program (QPP) measures that can be reported using a registry or billing claims. The remaining nine are specific pathology measures approved by the CMS as qualified clinical data registry (QCDR) measures—exclusively available in the Pathologists Quality Registry.

Pathologists Quality Registry QCDR Measures

Pathologists Quality Registry QPP Measures

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

QPP 99: Breast Cancer Resection Pathology Reporting Registry and Claims Specifications
QPP 100: Colorectal Cancer Resection Pathology Reporting Registry and Claims Specifications
QPP 249: Barrett Esophagus Pathology Reporting Registry and Claims Specifications
QPP 250: Radical Prostatectomy Pathology Reporting Registry and Claims Specifications
QPP 251: Evaluation of HER2 for Breast Cancer Patients Registry and Claims Specifications
QPP 395: Lung Cancer Reporting (biopsy/cytology specimens)** Registry and Claims Specifications 
QPP 396: Lung Cancer Reporting (resection specimens)** Registry and Claims Specifications 
QPP 397: Melanoma Reporting** Registry and Claims Specifications 


CAP Advocacy

The CAP advocates on behalf of pathologists regarding their options for quality reporting. While the CAP has created eight quality measures included in the current CMS quality program for pathologists, other measures in the current MIPS program may apply. In 2018, most specialties must report on a minimum of six measures.

The CMS recommends that eligible professionals check with the QualityNet HelpDesk for more information on which measures apply to you.

Professionals may contact the Qualitynet Help Desk.
7:00 AM–7:00 PM CT Monday - Friday
email: qnetsupport@hcqis.org
Phone: 866-288-8912

Claims-Based Instruction Sheet

The CAP developed a Claims-Based Instruction Sheet to help you submit data on quality measures for MIPS through claims. The corresponding 2018 QPP Reporting Codes can help on which codes to report.

Related Resources

Centers for Medicaid and Medicare Services (CMS)