Who is eligible for MIPS 145?

All final reports for procedures using fluoroscopy.

Is MIPS 145 the same as MIPS 145?

Yes. CMS uses zero-padded three-digit Quality IDs (145) in official specifications, while clinicians often search for MIPS 145 or Quality ID 145 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

How do I report MIPS Measure 145 in 2026?

MIPS Measure 145 (Quality ID 145) is reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM) via qualified registry, or Medicare Part B claims where applicable.

Is MIPS 145 a topped-out measure?

Yes, MIPS 145 is currently topped out, which means most clinicians perform well on this measure and it may be subject to a 7-point scoring cap.

Measure ID: MIPS 145|Imaging|2026 Performance Year

2026 MIPS Measure #145: Radiology: Exposure Dose Indices Reported for Procedures Using Fluoroscopy

Final reports for procedures using fluoroscopy that document radiation exposure indices.

Process – High PriorityImagingPatient SafetyRadiology

Measure ID:MIPS 145 (Quality ID 145)

Collection:MIPS CQM, Part B Claims

Topped Out:Yes

View CMS Spec ↗

Measure Specification

Eligible Population

Patient procedure during the performance period

Exclusions

None

Numerator

Final reports for procedures using fluoroscopy that include radiation exposure indices.

Reporting Codes

Performance Met:

G9500 Radiation exposure indices documented in final report for procedure using fluoroscopy

Performance Not Met:

G9501 Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given

VBCA Insights

Why This Measure Matters

When your team performs fluoroscopy procedures, this measure checks whether you're documenting the radiation dose your patient received. Tracking dose exposure helps reduce unnecessary radiation harm—studies show that practices monitoring fluoroscopy doses significantly lower patient exposure over time. Make it a routine part of your fluoroscopy workflow to record dose metrics like reference air kerma in the final report. Keeping dose top-of-mind also supports conversations with patients about radiation safety.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 145 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM) or through qualified registry submission.

🧮MIPS Score Simulator

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

Your Performance Rate:%Benchmarks vary by collection type

💡 Tip: Enter your performance rate to compare MIPS points across all collection types. The same rate can score differently depending on how you submit.

Specialty Measure Sets

Diagnostic Radiology Interventional Radiology

Related Measures

Imaging

MIPS 360: Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose MIPS 364: Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT MIPS 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions MIPS 406: Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients MIPS 415: Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt

Patient Safety

MIPS 130: Documentation of Current Medications in the Medical Record MIPS 155: Falls: Plan of Care MIPS 164: Coronary Artery Bypass Graft (CABG): Prolonged Intubation MIPS 168: Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration MIPS 181: Elder Maltreatment Screen and Follow-Up Plan MIPS 259: Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured MIPS 275: Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before MIPS 286: Dementia: Safety Concern Screening and Follow-Up for Patients with Dementia MIPS 351: Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular Risk MIPS 354: Anastomotic Leak Intervention MIPS 355: Unplanned Reoperation within the 30-Day Postoperative Period MIPS 357: Surgical Site Infection (SSI)MIPS 374: Closing the Referral Loop: Receipt of Specialist Report MIPS 384: Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating MIPS 385: Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement MIPS 392: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation MIPS 393: Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation,MIPS 413: Door to Puncture Time for Endovascular Stroke Treatment MIPS 422: Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse MIPS 432: Proportion of Patients Sustaining a Bladder or Bowel Injury at the time of any Pelvic MIPS 513: Patient Reported Falls and Plan of Care

Radiology

MIPS 360: Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose MIPS 406: Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients

Official Resources

📄 CMS Measure Specification (PDF)🔗 QPP Quality Payment Program

Clinical Rationale

Increasing physician awareness of patient exposure to radiation is an important step towards reducing the potentially harmful effects of radiation as a result of imaging studies. Studies have shown that dose monitoring for fluoroscopy procedures has resulted in an overall reduction in patient radiation exposure. Proper identification and management of patients receiving high doses of radiation from fluoroscopy procedures are essential elements of patient care due to the slowly developing nature of radiation-induced tissue reactions.

Clinical Recommendations

All available radiation dose data should be recorded in the patient’s medical record. Adequate recording of dose metrics is defined as documentation in the patient record of at least one of the following for all interventional procedures requiring fluoroscopy (in descending order of desirability): Ka,r, PKA, and PSD. Reference air kerma is the most useful and widely available of these metrics as it is required to be displayed on all fluoroscopes sold in the United States as of June 2006, however all three metrics are sufficient in estimating radiation exposure from fluoroscopic procedures.

(AAPM, 2022) More complete patient radiation dose data should be recorded for all high-dose interventional procedures, such as embolizations, transjugular intrahepatic portosystemic shunts, and arterial angioplasty or stent placement anywhere in the abdomen and pelvis. (Amis et al., ACR, 2007) PKA, also known as kerma-area product (KAP) or dose-area product (DAP), is the integral of air kerma (the energy extracted from an x-ray beam per unit mass of air in a small irradiated air volume; for diagnostic x-rays, the dose delivered to that volume of air) across the entire x-ray beam emitted from the x-ray tube.

It is a surrogate measure of the amount of energy delivered to the patient, and thus a reasonable indicator of the risk of stochastic effects. The symbol PKA is the notation recommended by the International Commission on Radiation Units and Measurements (ICRU, 2012).

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 procedure measure is submitted each time a procedure is performed during the performance period.

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