MIPS # PIMSH 13 Mutation Testing for Stage IV Lung Cancer Completed Prior to the Start of Targeted Therapy
2026 measure specification review pending.
MEASURE DESCRIPTION
Proportion of stage IV non-squamous NSCLC 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 non-squamous 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 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.
Numerator Note: Mutation testing may include solid tumor and/or liquid biopsy options
Denominator
Patients with stage IV non-squamous, NSCLC receiving treatment during the measurement period AND patient encounter during the performance period.
Denominator Note: Include patients with stage IV non-squamous, NSCLC diagnosed between July 1st of the previous performance period through the end of the current performance period
Exclusion/Exception
Patients on clinical trial.
Telehealth included: Yes
Scoring CMS did not establish benchmarks for 2026 for this measure. If reported will earn 0 points however, CMS can create same year benchmarks.
