Measure ID: MIPS 506·Oncology·2026 Performance Year

2026 MIPS Measure #506: Positive PD-L1 Biomarker Expression Test Result Prior to First-Line Immune Checkpoint

Percentage of patients aged 18 years and older with a diagnosis of metastatic non-small cell lung cancer (NSCLC) or squamous cell carcinoma of head and neck (HNSCC) on first-line immune checkpoint inhibitor (ICI) therapy, who had a positive PD-L1 biomarker expression test result prior to giving ICI therapy.

Process – High PriorityOncology
Measure ID:MIPS 506 (Quality ID 506)
Collection:MIPS CQM
Topped Out:No
View CMS Spec ↗

Measure Specification

Eligible Population
Patients aged 18 years and older on the date of the encounter
ANDDiagnosis for metastatic non-small cell lung cancer or squamous cell carcinoma of head and neck on the date of the encounter
ANDPatient encounters during the performance period
WITHOUTEncounters conducted via telehealth: M1426
ANDCurrently on first-line immune checkpoint inhibitors without chemotherapy: M1411
Exclusions
M1412Patients with metastatic NSCLC with epidermal growth factor receptor (EGFR) mutations, ALK genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as NSCLC with ROS1 rearrangement, BRAF V600E mutation, NTRK 1/2/3 gene fusion, MET ex14 skipping mutation, and RET rearrangement
Numerator
Patients who had a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy.
Reporting Codes

Performance Met:

M1413Patients who had a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy

Performance Not Met:

M1415Patients who did not have a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy

○ Exceptions:

M1414Documentation of medical reason(s) for not performing the PD- L1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patient’s health status; other medical reasons/contraindication)
VBCA Insights

Why This Measure Matters

Patients with advanced lung cancer or head and neck cancer who are starting immunotherapy should have PD-L1 testing beforehand—a positive result predicts better response to checkpoint inhibitors and helps guide first-line therapy. NCCN guidelines recommend PD-L1 testing for these populations before treatment starts. Work with your pathology and oncology teams to ensure testing happens upfront; delaying treatment for testing may not be necessary if you order it concurrently with initial workup.

VBCA is a CMS-approved Qualified Clinical Data Registry (QCDR) that submits MIPS Measure 506 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.

%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.

2026 MIPS 506 Benchmarks

Historical CMS benchmark deciles for MIPS quality measure 506 by collection type. Your performance rate falls into a decile, which determines your measure points (3–10).

MIPS CQM
DecilePerformance Rate RangePoints

Specialty Measure Sets

Oncology/Hematology

Related Measures

Oncology
MIPS 102: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk ProstateMIPS 143: Oncology: Medical and Radiation – Pain Intensity QuantifiedMIPS 144: Oncology: Medical and Radiation – Plan of Care for PainMIPS 249: Barrett’s EsophagusMIPS 250: Radical Prostatectomy Pathology ReportingMIPS 395: Lung Cancer Reporting (Biopsy/Cytology Specimens)MIPS 396: Lung Cancer Reporting (Resection Specimens)MIPS 397: Melanoma ReportingMIPS 401: Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with CirrhosisMIPS 450: Appropriate Treatment for Patients with Stage I (T1c) – III HER2 PositiveMIPS 453: Percentage of Patients who Died from Cancer Receiving Systemic Cancer-DirectedMIPS 457: Percentage of Patients who Died from Cancer Admitted to Hospice for Less than 3MIPS 490: Appropriate Intervention of Immune-Related Diarrhea and/or Colitis in Patients TreatedMIPS 491: Mismatch Repair (MMR) or Microsatellite Instability (MSI) Biomarker TestingMIPS 507: Appropriate Germline Testing for Ovarian Cancer PatientsMIPS 509: Melanoma: Tracking and Evaluation of Recurrence

Clinical Context

Clinical Rationale

The evidence-based NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer and NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer address the measure’s quality actions of a positive PD-L1 biomarker expression test prior to giving first-line immune checkpoint inhibitor therapy in the metastatic NSCLC or squamous cell carcinoma of head and neck populations.

The measure will enhance compliance with the clinical guidelines by ensuring the eligible provider addresses timely biomarker testing that makes a difference in treatment decisions and improves patient outcomes.

Clinical Recommendations

Biomarker testing that is not timely may make a difference in treatment decisions and/or patient outcomes. Appropriate treatment delivery could be delayed, or ineffective therapies could be prescribed, resulting in poor clinical outcomes and unnecessary healthcare costs (Pai et al., 20120 Lim et al., 2015).

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 will be used if the measure is submitted more than once.

Frequently Asked Questions

Who is eligible for MIPS 506?

Patients aged 18 years and older with a diagnosis of metastatic non-small cell lung cancer (NSCLC) or squamous cell carcinoma of head and neck (HNSCC) and on first-line immune checkpoint inhibitors without chemotherapy Definitions: Immune checkpoint inhibitors – Class of medications that prevent tumors from “hiding” or “evading” the body’s natural immune system. This is a form of cancer immunotherapy. Immune checkpoint inhibitor medications include PD-1 inhibitor drugs, PD-L1 inhibitor drugs, and CTLA-4 inhibitor drugs. • PD-1 inhibitors drugs include: Pembrolizumab, Nivolumab, Cemiplimab • PD-L1 inhibitor drugs include: Atezolizumab • CTLA-4 inhibitor drugs include: Ipilimumab First-line treatment – Initial or first treatment recommended for cancer • Various treatment regimens were considered, including immune checkpoint inhibitors • PD-L1 testing required per FDA approval for the applicable histology Denominator Instructions: Additionally, immune checkpoint inhibitors FDA approved for specific histology must meet the following criteria to be considered denominator eligible: • Pembrolizumab (PD-1 inhibitor drug) AND o first-line treatment in patients with metastatic NSCLC o OR first-line treatment in patients with metastatic HNSCC • Cemiplimab (PD-1 inhibitor drug) AND o first-line treatment in patients with metastatic NSCLC • Atezolizumab (PD-L1 inhibitor drug) AND o first-line treatment in patients with metastatic NSCLC • Nivolumab (PD-1 inhibitor drug) and Ipilimumab (CTLA-4 inhibitor drug) combination AND o first-line treatment in patients with metastatic NSCLC

Is MIPS 506 the same as MIPS 506?

Yes. CMS uses zero-padded three-digit Quality IDs (506) in official specifications, while clinicians often search for MIPS 506 or Quality ID 506 without the leading zero. Both refer to the same 2026 MIPS quality measure reported through the Quality Payment Program (QPP).

What codes do I submit for MIPS 506: Positive PD-L1 Biomarker Expression Test Result Prior to First-Line Immune Checkpoint?

Submission codes: M1413 (Patients who had a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy); M1415 (Patients who did not have a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy)

How do I report MIPS Measure 506 in 2026?

MIPS Measure 506 (Quality ID 506) 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 506 a topped-out measure?

No, MIPS 506 is not topped out, meaning there is still meaningful performance variation across clinicians.

Report this measure through VBCA

Our QCDR handles measure selection, data validation, and submission—so you can focus on clinical performance.

Learn About Our QCDR →Talk to Us →

© 2025 Society for Immunotherapy of Cancer (SITC). All Rights Reserved.