MIPS # PIMSH 13 Mutation Testing for Stage IV Lung Cancer Completed Prior to the Start of Targeted Therapy

2025: no changes from 2024

MEASURE DESCRIPTION: Proportion of stage IV nsNSCLC patients tested for actionable biomarkers and received targeted therapy or chemotherapy based on biomarker results.

Relevance to Value Based Care: Recent discovery of some of the driver mutations for NSCLC have advanced more individualized and targeted treatment options. It is now a standard recommendation that patients with advanced NSCLC undergo routine molecular testing to identify certain abnormalities which influence treatment selection to improve efficacy.

 Numerator: Patients who received mutation testing for all actionable biomarkers at Stage IV diagnosis of nsNSCLC (including NTRK1/2/3, RET, MET, ROS1, EGFR, EGFR T790M, BRAF mutation, ALK rearrangement, CD274(PD-L1), KRAS, ERBB2 mutation) AND lung cancer treated with appropriate mutation-directed therapy or standard chemotherapy if biomarker results are negative.

 Denominator: Patients with stage IV non-squamous, NSCLC receiving initial treatment during the measurement period AND patient encounter during the performance period.

Telehealth included: Yes 

Exclusion/Exception: Lack of tissue for testing OR insufficient test results

 Scoring

CMS did not establish benchmarks for 2025 for this measure. If reported will earn 0 points unless CMS creates same year benchmarks.

 RESOURCES