The Merit-based Incentive Payment System (MIPS) continues to evolve, and the 2025 performance year brings new opportunities and challenges for healthcare providers. With updated performance thresholds, category requirements, and the growing prominence of MIPS Value Pathways (MVPs), staying informed and proactive is more important than ever. This guide will walk you through actionable steps to ensure your practice succeeds in 2025 MIPS reporting.
1. Understand the 2025 MIPS Performance Thresholds
The performance threshold for 2025 remains at 75 points. Clinicians must meet or exceed this score to avoid penalties.
The exceptional performance bonus has been phased out, but achieving a higher score still improves your chances of positive payment adjustments.
Pro Tip: Focus on high-performing categories like Quality and Promoting Interoperability (PI) to boost your score.
2. Choose the Right Reporting Mechanism
With multiple reporting mechanisms available, it’s essential to choose one that aligns with your practice’s strengths:
eCQMs (Electronic Clinical Quality Measures): Ideal for practices with robust EHR integration.
Medicare Part B Claims: Available for small practices (≤15 clinicians).
Registry Submission: Offers flexibility for specialty-specific measures.
MIPS Value Pathways (MVPs): A streamlined option for 2025 with new pathways for dermatology, cardiology, and more.
Pro Tip: Evaluate your previous year’s performance to determine which mechanism yields the best results for your practice.
3. Focus on Each Performance Category
Quality (30% of Final Score)
Submit at least 6 measures, including one outcome measure.
Meet the 75% data completeness requirement by reporting on at least 75% of eligible patients.
Cost (30% of Final Score)
CMS calculates this category automatically based on claims data. Ensure your coding is accurate and complete to reflect your practice’s cost efficiency.
Promoting Interoperability (PI) (25% of Final Score)
Use Certified EHR Technology (CEHRT) and meet key interoperability measures, including Health Information Exchange (HIE) and e-Prescribing.
Apply for reweighting if you face significant challenges, such as technical issues with your EHR.
Improvement Activities (IA) (15% of Final Score)
Small practices can attest to one high-weighted activity or two medium-weighted activities to fulfill this category.
Pro Tip: A MIPS consultant can help you identify the best measures and activities for your specialty.
4. Explore MIPS Value Pathways (MVPs)
For 2025, CMS has introduced six new MVPs, expanding options for specialties like urology, pulmonology, and surgical care. MVPs are designed to:
Simplify reporting by focusing on specialty-relevant measures.
Align quality, cost, and improvement activities for streamlined scoring.
Pro Tip: If you’re transitioning to an MVP, register your intent with CMS by November 30, 2025, and ensure your team is prepared for the new reporting structure.
5. Stay Ahead of Deadlines
Timely submission is crucial for MIPS success. Key dates to remember:
Data Collection Period: January 1 – December 31, 2025.
Data Submission Deadline: March 31, 2026.
Pro Tip: Submit your data early to avoid last-minute errors or system delays.
6. Apply for Hardship Exemptions
If you encounter unforeseen challenges, such as natural disasters or EHR issues, consider applying for an Extreme and Uncontrollable Circumstances (EUC) exemption. This can reweight categories like PI or Cost, ensuring your score isn’t unfairly impacted.
7. Partner with a MIPS Consultant
Navigating the complexities of MIPS can be overwhelming, but a MIPS consultant can:
Help you select the best measures and reporting mechanisms.
Monitor your performance throughout the year.
Ensure accurate data submission and audit readiness.
Pro Tip: Working with a consultant can maximize your score and minimize the administrative burden on your team.
Success in MIPS for 2025 requires careful planning, consistent tracking, and an understanding of updated requirements. By focusing on high-performing categories, exploring MVPs, and staying ahead of deadlines, your practice can achieve a competitive score and secure positive payment adjustments.
If you’re ready to optimize your MIPS strategy, contact us today to learn how our consulting services can help you navigate the 2025 performance year with confidence.
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