As part of the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program, the merit-based incentive payment system—commonly known as MIPS—continues to evolve each year to promote high-quality, efficient care while incentivizing improvements in patient outcomes.
In 2025, MIPS brings a new set of requirements, scoring methods, and performance categories. At CureMD, our experts are here to support you every step of the way, so you can ensure compliance and maximize reimbursement.
MIPS is a CMS program that measures and adjusts Medicare payments to healthcare providers based on their performance in several categories. Providers are evaluated annually on their ability to deliver high-quality care while managing costs, improving patient experience, and adopting advanced healthcare technology.
MIPS rewards those healthcare providers who meet and exceed certain quality benchmarks and penalizes those who do not. The program encourages healthcare providers to participate in value-based care, improve care quality, and reduce healthcare costs.
The four key performance categories of MIPS—which include quality, cost, improvement activities, and promoting interoperability—remain largely the same, but with new updates and weightings that reflect the shifting healthcare landscape:
In response to growing evidence of healthcare disparities, CMS has introduced new measures designed to promote care for underserved and marginalized communities. Practices that demonstrate a commitment to reducing health disparities and providing equitable care will earn greater rewards in their MIPS scores.
Key updates include the following:
In 2025, the quality category will still make up the largest portion of the MIPS score, but the cost category will also receive increased weight. CMS aims to incentivize healthcare providers to deliver high-quality care while managing costs effectively.
With cost now representing a larger portion of the MIPS score, practices will need to ensure they are not only delivering high-quality care but also optimizing their resource usage and minimizing unnecessary spending.
The promoting interoperability category is evolving in 2025 to emphasize data exchange and patient access to information. CMS continues to push for greater interoperability between electronic health record (EHR) systems, healthcare organizations, and patients.
Key updates include the following:
In 2025, CMS updated many of the quality measures used in MIPS. These updates aim to reflect the latest clinical practices and healthcare trends. Several new measures will address emerging needs in areas like telemedicine, chronic disease management, and mental health.
Practices are required to report on a specific set of measures, including:
CMS also introduced new options for specialty practices and telemedicine providers to help ensure that their unique care delivery models are appropriately reflected in their MIPS score.
To continue fostering participation among small practices, CMS has introduced additional flexibility for practices with fewer than 15 clinicians. This includes:
In 2025, MIPS introduces several updates that will affect reporting requirements, performance metrics, and reimbursement rates. These changes reflect CMS’s ongoing focus on improving healthcare quality, reducing disparities, and enhancing the patient experience. Here’s a breakdown of the major changes to MIPS for 2025:
Quality continues to be a core component of MIPS, focusing on a provider’s ability to deliver high-value care. Healthcare providers must report on a set of clinical quality measures and show evidence of improvement over time. The quality measures will include a combination of outcome measures, patient experience metrics, and other clinical benchmarks.
Key updates for 2025: New and revised quality measures that reflect changes in clinical guidelines and health priorities.
The cost category has been expanded to now represent 40% of the total MIPS score. This category evaluates the efficiency of care by considering total healthcare spending for an attributed population. Cost measures include metrics like Medicare Spending per Beneficiary (MSPB) and Total Per Capita Cost (TPCC).
Key updates for 2025: New cost measures related to chronic disease management and telehealth utilization.
The improvement activities category rewards practices for taking action to improve care delivery, address health disparities, and improve patient engagement. Practices must complete a set of activities designed to increase care quality, patient access, and engagement with the healthcare system.
Key updates for 2025: More activities focused on reducing health disparities and promoting team-based care.
The promoting interoperability category focuses on the use of certified EHR technology. Providers must demonstrate meaningful use of EHRs to improve patient care coordination, data exchange, and patient access to their own health data.
Key updates for 2025: Expanded requirements for data sharing with other providers and public health organizations, and new measures focused on patient engagement.
Providers receive scores in each of the four categories, and those scores are combined into an overall MIPS score. The MIPS score ranges from 0 to 100 points, with higher scores indicating better performance.
The MIPS score is used to determine payment adjustments for the following year. The better a provider’s score, the more likely they are to receive a positive payment adjustment, which means higher reimbursement for services provided to Medicare patients. Conversely, poor performance results in negative payment adjustments, or reduced reimbursement.
The performance in each category is calculated as a score, and then those scores are weighted according to the percentages above. The resulting MIPS Composite Score is a final score between 0 and 100.
A provider’s performance in each of the four categories—quality, cost, improvement activities, promoting interoperability—is scored.
Each category score is multiplied by its respective weight.
The weighted category scores are then added together to produce a final MIPS Composite Score.
For example, if a provider scores 80 points for quality (30% weight), 70 points for cost (30% weight), 90 points for improvement activities (15% weight), and 85 points for promoting interoperability (25% weight), the composite score would be calculated as:
(80×0.30)+(70×0.30)+(90×0.15)+(85×0.25)
24+21+13.5+21.25
79.75
At CureMD, we understand that the ever-changing landscape of MIPS can be overwhelming, which is why we’re committed to providing the tools and support that healthcare providers need to succeed. Our comprehensive, cloud-based EHR and practice management solutions are designed to streamline MIPS reporting and help you:
CureMD automatically tracks and reports MIPS data, ensuring compliance with all CMS reporting requirements. Our MIPS dashboard allows you to monitor performance in real-time.
We keep you updated with real-time changes to quality measures, cost measures, and reporting thresholds, so you never have to worry about missing an important update.
With CureMD’s robust reporting and analytics features, you can identify areas for improvement and maximize your MIPS score by focusing on the metrics that matter most.
CureMD’s certified EHR technology supports seamless data exchange between providers, helping you meet the requirements of the promoting interoperability category.
Our tools support practices in tracking and improving care for diverse patient populations, ensuring that you’re well-positioned to earn additional rewards for focusing on health equity.
CureMD is here to help you navigate the changes of MIPS in 2025. Whether you’re a new participant or an experienced MIPS reporter, we’ll guide you through every step of the process.
Want to learn more? Schedule a demo of CureMD’s MIPS tools to see how our software can help streamline reporting and improve your performance.
Have questions about MIPS 2025? Learn more by catching up with our FAQs About MIPS.
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