MIPS #PIMSH 17 Oncology: Utilization of Prophylactic GCSF for Cancer Patients Receiving Low-Risk Chemotherapy (Inverse Measure)

New measure for 2025. Practice Insights coding updates pending.

This is an inverse measure. Lower score indicates better performance.

Measure Description: Percentage of patients with cancer (solid tumors only) receiving any white cell growth factors with during the first cycle of low-risk chemotherapy.

Relevance to Value Based Care: ASCO guidelines recommend using white cell stimulating factors when the risk of febrile neutropenia, secondary to a recommended chemotherapy regimen, is approximately 20 percent and equally effective treatment programs that do not require white cell stimulating factors are unavailable. GCSF prophylaxis should be used for patients when there is a significant risk of developing febrile neutropenia. 

ASCO states that despite the widespread use of GCSFs, their use as primary prophylaxis of febrile neutropenia in the clinical setting varies widely and is inconsistent with guidelines. In the palliative setting, dose escalation has not been demonstrated to improve outcomes or quality of life.

 Scoring

 Measure in 1st reporting year, 7-point floor. CMS may create same-year benchmarks after submission.

RESOURCES

See attached documents below that list the solid tumor codes and the low-risk regimes included in this measure.