MIPS for Pathologists

Under MIPS, pathologists are included if they are an eligible clinician type and meet the low volume threshold, which is based on allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS) and the number of Medicare Part B patients who are furnished covered professional services under the Medicare Physician Fee Schedule.

Performance is measured through the data clinicians report in four areas - Quality, Improvement Activities, Promoting Interoperability (formerly Advancing Care Information), and Cost. CMS designed MIPS to update and consolidate previous programs, including: Medicare Electronic Health Records (EHR) Incentive Program for Eligible Clinicians, Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier (VBM).

Because the program rules change from year to year, the CAP has organized the content based on the performance year (PY).

Performance Years

2021 Reporting Timeline

  • Performance period opened January 1, 2021
  • Performance period ends December 31, 2021
  • Report 2021 data by March 31, 2022
  • Feedback available July 2022
  • Payment adjustment implemented (+/- 9%) January 1, 2023

2020 vs 2021 MIPS Reporting Requirements

2021 Pathology Quality Measures

2021 MIPS Improvement Activities

Promoting Interoperability (PI) and Cost Categories

2021 Small vs Large Practices

Additional Resources

2020 Reporting Timeline

  • Performance period opened January 1, 2020
  • Performance period ends December 31, 2020
  • Report 2020 data by March 31, 2021
  • Feedback available July 2021
  • Payment adjustment implemented (+/- 9%) January 1, 2021

2019 vs 2020 MIPS Reporting Requirements

2020 Quality Pathology Measures

2020 MIPS Improvement Activities

Promoting Interoperability (PI) and Cost Categories

2020 Small vs Large Practices

Additional Resources

Pathologists Quality Registry

Optimize your performance in MIPS and enroll for the 2021 reporting period.

Learn more about the registry Right Arrow

We have a dedicated team to help you navigate to MIPS reporting success.

Email: mips@cap.org 

Phone: 800-323-4040, option 3