New Draft Measures for 2027 MIPS

The ACR^® Qualified Clinical Data Registry (QCDR) team is already preparing for the 2027 Merit-Based Incentive Payment System (MIPS) performance year. For 2027, ACR intends to submit three new QCDR measures for CMS consideration, in addition to the measures currently available via the ACR QCDR. These new measures are:

1. Use of NI-RADS Reporting in Post-Treatment Surveillance Imaging for Mucosal Head and/or Neck Squamous Cell Carcinoma
   This measure examines cases of patients with a history of treated mucosal head/neck squamous cell carcinoma undergoing post-treatment surveillance imaging. Cases that meet numerator performance must include both a description of the primary tumor site and lymph nodes using terminology mapping to ACR Neck Imaging Reporting & Data System (NI-RADS™) categories and an impression section with corresponding NI-RADS management recommendations.
   
   
2. DXA: Improving Reporting of True Change in Bone Mineral Density
   This measure was added to the QCDR in performance year 2025, but was removed for 2026 due to lack of reporting data. ACR eventually received enough data to complete the required testing process for the measure, so we are hopeful that CMS will agree to add this measure back for 2027.
   
   Additionally, ACR submitted this measure to the CMS Call for Measures this year. This is the first step in the process of having a measure added to the MIPS program as an official MIPS Clinical Quality Measure (CQM). ACR is happy to report that the measure was approved to move on to the “Measures Under Consideration” list, which means it is one step closer to potentially being added as a future MIPS CQM. We will likely know more once CMS releases the 2027 Medicare Physician Fee Schedule (MPFS) Proposed Rule.
   
   
3. Anatomical Landmark-Based Vertebral Numbering in Spine MRI Reports
   This measure's intention is to improve diagnostic accuracy and reduce wrong-level spine surgery by ensuring spinal MRI reports consistently number vertebrae using anatomical landmarks and describe any irregularities and anomalies in relation to those landmarks. Cases that meet the numerator should include vertebral numbering based on anatomical landmarks, and if the count is abnormal, should include a description of the landmark used.

MIPS 2026 Updates

The ACR QCDR supports twelve QCDR measures and a large selection of MIPS measures in 2026. Additionally, the ACR QCDR will support the reporting of the new Diagnostic Radiology and Interventional Radiology MIPS Value Pathways (MVPs).

Of relevance to groups participating in 2026 MIPS, ACR continues to make strides in streamlining the reporting process for eCQM #494, “Excessive Radiation Dose or Inadequate Image Quality in Adult CT.” Since this eCQM is currently the only Outcome measure available in the Diagnostic Radiology MVP, ACR wishes to assist anyone interested in submitting this measure.