New 2025 MIPS Measure Evaluates CT Exam Dose and Image Quality

The ACR National Radiology Data Registry (NRDR®) is a CMS-approved Qualified Clinical Data Registry (QCDR) for the Merit-based Incentive Payment System (MIPS) for 2025. In 2025, the NRDR QCDR allows users to report on a new diagnostic radiology MIPS measure, eCQM 494: Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) for Adults. This measure has replaced MIPS CQM 436: Radiation Consideration for Adult CT: Utilization of Dose-Lowering Techniques, which is no longer included in the program as of 2025.

eCQM 494 is an inverse measure which evaluates the dose and image quality of each CT exam across different exam categories. Each exam that falls above either the CT size-adjusted dose or the CT global noise threshold for its exam category will be considered as “performance met” (which is the undesirable outcome for inverse measures).

As an eCQM (electronic clinical quality measure), this new measure requires a different data collection and upload process from standard MIPS measures. Rather than manually populating a data template with information extracted from the EHR, users must use software to extract the measure’s data elements. ACR has been working closely with Alara Imaging, the measure sponsor, to assist those considering reporting on this measure using Alara’s data collection software. If you are interested in reporting on this measure in 2025 or 2026, please reach out to the ACR NRDR team.

As a reminder, the ACR NRDR QCDR also supports five new QCDR measures in 2025:

• ACRad43: DXA: Improving Reporting of True Change in Bone Mineral Density
  
• QMM23: Low-Dose Cancer Screening Recommendations for CT of Chest With Diagnosis of Emphysema
  
• QMM24: Acute Rib Fracture Numbering on ED Trauma Patients
  
• QMM27: Appropriate Classification and Follow-up Imaging for Incidental Pancreatic Cysts
  
• QMM28: Reporting Breast Arterial Calcification (BAC) on Screening Mammography

For more information, access a full list of 2025 MIPS Measures and 2025 QCDR Measures available via the ACR QCDR.