Is MIPS 453 the same as MIPS 453?

Yes. CMS uses zero-padded three-digit Quality IDs (453) in official specifications, while clinicians often search for MIPS 453 or Quality ID 453 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

What is the NQF number for MIPS Measure 453?

MIPS Measure 453 is associated with CBE/NQF number 210. It can be reported through the Quality Payment Program (QPP) as a MIPS Clinical Quality Measure (CQM).

How do I report MIPS Measure 453 in 2026?

MIPS Measure 453 (Quality ID 453) 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 453 a topped-out measure?

No, MIPS 453 is not topped out, meaning there is still meaningful performance variation across clinicians.

Measure ID: MIPS 453|Oncology|2026 Performance Year

2026 MIPS Measure #453: Percentage of Patients who Died from Cancer Receiving Systemic Cancer-Directed

Percentage of patients who died from cancer receiving systemic cancer-directed therapy in the last 14 days of life.

Process – High PriorityOncologyPalliative Care

Measure ID:MIPS 453 (Quality ID 453)

CBE:210

Collection:MIPS CQM

Topped Out:No

View CMS Spec ↗

Measure Specification

Eligible Population

Diagnosis for cancer

ANDAt least two patient encounters during the performance period

ANDPatients who died from cancer: G9846

Exclusions

None

Numerator

Patients who received systemic cancer-directed therapy in the last 14 days of life.

Reporting Codes

Performance Met:

G9847Patient received systemic cancer-directed therapy in the last 14 days of life

Performance Not Met:

G9848Patient did not receive systemic cancer-directed therapy in the last 14 days of life

VBCA Insights

Why This Measure Matters

Chemotherapy in the final days of life is associated with worse quality of death, more ICU admissions, and higher costs without improving survival. This measure is an inverse measure—lower rates are better—that tracks patients who received chemotherapy in their last 14 days. If you see high rates, it signals a need for earlier end-of-life conversations and better integration of palliative care alongside oncology so patients can focus on comfort.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 453 to the Quality Payment Program (QPP). Practices can report this measure as a MIPS Clinical Quality Measure (CQM) or through qualified registry submission.

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Specialty Measure Sets

Oncology/Hematology Urology

Related Measures

Oncology

MIPS 102: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate MIPS 143: Oncology: Medical and Radiation – Pain Intensity Quantified MIPS 144: Oncology: Medical and Radiation – Plan of Care for Pain MIPS 249: Barrett’s Esophagus MIPS 250: Radical Prostatectomy Pathology Reporting MIPS 395: Lung Cancer Reporting (Biopsy/Cytology Specimens)MIPS 396: Lung Cancer Reporting (Resection Specimens)MIPS 397: Melanoma Reporting MIPS 401: Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis MIPS 450: Appropriate Treatment for Patients with Stage I (T1c) – III HER2 Positive MIPS 457: Percentage of Patients who Died from Cancer Admitted to Hospice for Less than 3 MIPS 490: Appropriate Intervention of Immune-Related Diarrhea and/or Colitis in Patients Treated MIPS 491: Mismatch Repair (MMR) or Microsatellite Instability (MSI) Biomarker Testing MIPS 506: Positive PD-L1 Biomarker Expression Test Result Prior to First-Line Immune Checkpoint MIPS 507: Appropriate Germline Testing for Ovarian Cancer Patients MIPS 509: Melanoma: Tracking and Evaluation of Recurrence

Palliative Care

MIPS 386: Amyotrophic Lateral Sclerosis (ALS) Patient Care Preferences MIPS 457: Percentage of Patients who Died from Cancer Admitted to Hospice for Less than 3 MIPS 495: Ambulatory Palliative Care Patients’ Experience of Feeling Heard and

Official Resources

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

Clinical Rationale

Cancer is the second leading cause of death in the United States). Chemotherapy utilization at the end of life is associated with a worse quality of life near death among patients with good baseline performance status, ED visits, cardiopulmonary resuscitation, mechanical ventilation, dying in an ICU, and higher estimated costs of care. The 2015 Institute of Medicine report Dying in America states that a palliative approach often offers the best chance of maintaining the highest possible quality of life for those living with advanced serious illness and proposes, as a core component to quality end-of-life care, to offer palliative care services and personalize revision of the care plan and access to services based on the changing needs of the patient and family.

The purpose of this measure is to encourage timely enrollment in palliative care that focuses on symptom management, rather than low utility and aggressive treatments, among dying cancer patients. The ultimate outcome is an improved quality of life, positive death experience, and reduction in resource utilization costs. Lastly, the National Comprehensive Cancer Network (NCCN) Quality and Outcomes Committee recently reviewed 528 existing oncological quality measures and concepts to identify important cancer quality and outcome measures.

Measures and concepts were evaluated according to importance, supporting evidence, opportunity for improvement, and ease of measurement; CBE 0210 was one of seven cross-cutting measures selected for endorsement as a universally appropriate measure to evaluate quality of oncology care.

Clinical Recommendations

This measure is based on ASCO and National Comprehensive Cancer Network (NCCN) Guidelines: 1. Clinicians should refer patients with advanced solid tumors and hematologic malignancies to specialized interdisciplinary palliative care teams that provide inpatient and outpatient care early in the course of disease, alongside active treatment of their cancer (Moderate, Strong) (ASCO, 2024).

2. Palliative care for patients with advanced cancer should be delivered through interdisciplinary palliative care teams, with consultation available in both outpatient and inpatient settings (Intermediate, Moderate) (ASCO, 2024). 3. Patients with advanced cancer should receive palliative care services, which may include a referral to a palliative care provider.

Essential components of palliative care include (Intermediate, Moderate) (ASCO 2024): • Rapport and relationship building with patient and family caregivers • Symptom, distress, and functional status management (eg, pain, dyspnea, fatigue, sleep disturbance, mood, nausea, or constipation) • Exploration of understanding and education about illness and prognosis • Clarification of treatment goals • Assessment and support of coping and spiritual needs • Assistance with medical decision making • Coordination with other care providers • Provision of referrals to other care providers as indicated 4.

“In general, patients with weeks to days to live (e.g., dying patients) and comfort-oriented goals should discontinue all treatments not directly contributing to patient comfort. Intensive palliative care focusing on symptom management should be provided in addition to preparation for the dying process. Referral for hospice care should be placed, if not already done” (Category 2A) (NCCN, 2024).

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-periodic measure should be submitted a minimum of once per patient per timeframe specified by the measure for the performance period. This is an inverse measure which means a lower calculated performance rate for this measure indicates better clinical care or control.

The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.

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