AMA Update on MIPS

CMS Releases 2025 MIPS Final Scores- Physicians Have 60 Days to Contest Their Score

The Centers for Medicare & Medicaid Services (CMS) has released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2025 performance year. 2025 final score determines the payment adjustment eligible clinicians (ECs) and group practices will receive in 2027. 2027 MIPS payment adjustments will be available in approximately one month. If an EC or group practice believes CMS calculated their final score or 2027 payment adjustment incorrectly, you must file a targeted review with CMS within 60 days.

The targeted review opens with the release of final scores (now) and will close 30 days after the release of MIPS payment adjustments. CMS will announce the release of MIPS payment adjustments through the QPP listserv in approximately one month.CMS generally requires documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required. If the targeted review request is approved and results in a scoring change, CMS will update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible.

Examples of reasons to file a targeted review:

• Data were submitted under the wrong TIN or National Provider Identifier (NPI).
• You have Qualifying APM Participant (QP) status and shouldn’t receive a MIPS payment adjustment.
• Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

To access your MIPS final score and performance feedback and request a targeted review:

• Sign in using your HARP credentials (ACO-MS credentials for Shared Savings Program ACOs); these are the same credentials that allowed you to submit your 2025 MIPS data.
• Click “Targeted Review” on the left-hand navigation.

Please note, unfortunately targeted review decisions are final and aren’t eligible for further review by CMS.

CMS Would Like to Hear from You Regarding MIPS Value Pathways (MVPs)

CMS is conducting an MVP adoption survey and is seeking input from practices whether you have reported an MVP for Payment Year (PY) 2025, are preparing to report for PY 2026, or have not yet begun adopting an MVP. The AMA encourages physicians and practices to complete the survey, especially if you are concerned with CMS’ proposal in the 2027 Medicare Physician Fee Schedule Proposed Rule to sunset traditional MIPS and require MVP reporting-only starting in 2029. The AMA will continue to strongly advocate against mandatory MVP reporting and the need to maintain traditional MIPS along with reforms to the program to reduce administrative burden and make the program more relevant.

Participation in the survey is voluntary and confidential.   Responses will be reported to CMS in aggregate to protect the identity of individuals, groups, and entities. Eligible clinicians may receive Improvement Activity (IA) credit for completing the survey.   Take the survey by using this link:The MVP Adoption Survey. If you have questions, contact qppuserresearch@cms.hhs.gov