Measure ID: MIPS 112|Breast Cancer|2026 Performance Year

Breast Cancer Screening

Percentage of women 40 - 74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the measurement period.

ProcessBreast CancerPreventive Care

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

Patients 41 to 74 years of age at the beginning of the measurement period
ANDPatient encounter during the performance period

Denominator Exclusions6

G9708Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
G9709Hospice services used by patient any time during the measurement period
G9992Palliative care services used by patient any time during the measurement period
G9898Patients age 66 or older in Institutional Special Needs Plans (SNP) or residing in long term care with POS code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period
G2098Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period AND a dispensed medication for dementia during the measurement period or the year prior to the measurement period
G2099Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period AND an advanced illness diagnosis during the measurement period or the year prior to the measurement period: G2099

Numerator

Women with one or more mammograms any time on or between October 1 two years prior to the measurement period and the end of the measurement period.

Submission Codes (QDCs)

✓ Performance Met
G9899Screening, diagnostic, film, digital or digital breast Tomosynthesis (3D) mammography results documented and reviewed
✗ Performance Not Met
G9900Screening, diagnostic, film, digital or digital breast Tomosynthesis (3D) mammography results were not documented and reviewed, reason not otherwise specified

Denominator Exceptions

None — this measure has no denominator exceptions.

🧮MIPS Score Simulator

Estimate only — actual CMS scoring may vary based on reporting method, data completeness, and annual rule updates.

No benchmarks available for this measure.

VBCA Insights

💡Why This Measure Matters

This measure tracks mammogram screening rates in women aged 40-74 to catch breast cancer early when treatment is most effective. Mammography substantially reduces breast cancer deaths; routine screening every 2-3 years is recommended for average-risk women. Document screening results in the chart and establish a system to remind eligible women when screening is due. Discuss benefits and risks with each patient to support informed choice.

📖Clinical Rationale

Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S.. In 2015, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime. While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor.

Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years. The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 68; by age 50 it becomes 1 in 43; by age 60, it is 1 in 29.

📝Clinical Recommendations

The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 40-74 years (B recommendation) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement) (USPSTF, 2024). The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement) (USPSTF, 2024).

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, in women identified to have dense breasts on an otherwise negative screening mammogram (I statement) (USPSTF, 2024). The National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR) recommend using conventional mammography or DBT for screening women at low, intermediate or high risk for breast cancer (NCCN, 2021) (ACR, 2017).

📋Implementation Notes

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this patient-process measure is submitted a minimum of once per patient during the performance period. The most advantageous quality data code (QDC) will be used if the measure is submitted more than once.

This measure specification is only available for MIPS Value Pathway (MVP) reporting and is not available for traditional MIPS reporting.

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