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Measure 265

Biopsy Follow-Up

Description: The percentage of new patients whose biopsy results have been reviewed and communicated to the PCP or referring physician and the patient.

Measure ID: 265

Type: Process

CMS Derm Specialty Set: Yes

High priority: Yes

Topped out: Yes

Reporting methods: Registry/QCDR

Maximum points: 7

Measure purpose: This measure encourages care coordination by ensuring that clinicians review and communicate biopsy results to the primary care physician (PCP) or referring physician and the patient.


The numerator: The number of patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and the patient by the provider and/or office and medical team.


The denominator: All patients undergoing a biopsy.

Measure calculation example

Dr. Nader took biopsies from 189 patients during the reporting period. This is the denominator.

Of the 189 patients, Dr. Nader reviewed and communicated biopsy results 92 times. This is the numerator.

Quality of patient care = 92/189. Dr. Nader has a score of 48.7% for this measure. This translates to 3 points.

Important note

Because of how this measure is structured, physicians score 3 points even if they report on only one patient. Physicians receive no additional score for reporting scores that fall below 61.23%. For example, if Dr. Nader reported on one patient encounter, he would earn 3 points.

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Quality measure score benchmark

CMS will award points based on a comparison of your performance rate to CMS benchmarks listed below. Reach the performance rate listed to achieve the corresponding points per measure. The maximum points you can achieve for the quality score is 45 points.

Below 3 Decile 3Decile 4Decile 5Decile 6Decile 7
Performance rate  1 patient  61.23 - 83.62
83.63 - 
95.65 - 99.37
99.38 - 99.99
Points  3 points  3 - 3.9  4 - 4.9 5 - 5.9 6 - 6.9