2025 MIPS Reporting: Key Changes and What You Should Do

The Merit-based Incentive Payment System (MIPS) is the main way Medicare rewards providers for delivering better, more efficient care while keeping costs down.

If you bill Medicare, MIPS can shape how much you’re paid—through bonuses for high performance or penalties for falling short.

In 2025, MIPS reporting is even more important. The Centers for Medicare & Medicaid Services (CMS) has kept the core program structure in place but has introduced fresh requirements and higher expectations. Practices that ignore these changes risk missing out on incentives—or worse, facing payment cuts.

This year brings a bigger focus on real results, not just checking boxes. Providers who prepare now can not only avoid negative payment adjustments but also earn higher reimbursements and strengthen their patient care.

What Doesn’t Change in 2025

Most of the basic structure of MIPS still stands for 2025, so practices can build on what they already know.

The four core reporting categories remain: Quality, Cost, Improvement Activities, and Promoting Interoperability.
Category weights are unchanged: Quality (30%), Cost (30%), Promoting Interoperability (25%), Improvement Activities (15%).
The minimum performance threshold to avoid penalties is still 75 points, with data completeness set at 75% for submitted measures.
MVPs (MIPS Value Pathways) and traditional reporting both continue as options, without a total overhaul in requirements.

Knowing what’s stable helps you focus your energy on the new changes—keeping your reporting efficient and less stressful.

Changes by Performance Category

Quality

CMS has updated, added, and removed multiple measures for the 2025 performance period; there are now 195 quality measures available.
Providers must continue to report for the whole year, but there’s more focus on selecting outcome-based or high-priority measures, not just basic process tasks.
Updated policies for handling multiple submissions clarify which scores count if submitted by different admins or organizations.

Cost

Significant updates to cost measures expand what counts toward cost scoring (e.g., for certain procedures, more related services and medical equipment are now included).
New episode-based cost measures refine how the whole patient journey, readmissions, and related visits or services impact scoring.

Improvement Activities

While the core activities remain, there’s a growing emphasis on health equity and population health, with new or updated activities that reward outreach and care to underserved groups.

Promoting Interoperability

Tech requirements are updated, but basic expectations (secure data exchange, patient access, etc.) remain similar.
Practices should ensure their systems meet new interoperability, patient-access, and data reporting standards.

Higher Bar for 2025 — Scores, Bonuses & Penalties

The minimum score to avoid a penalty remains at 75 points, but it’s harder to earn—every category matters, and you must hit data completeness for 75% of eligible cases.
Cost scoring now aligns fully with the overall threshold, giving average and above-average practices fairer results. Lower-than-average cost performance brings down your score, while better-than-average can boost it.
All improvement activities now carry equal weight—no more high or medium scores—making activity selection straightforward.
Bonus opportunities are available for health equity improvements and patient engagement, especially if you go beyond basic requirements.
Penalties can reach -9% on future Medicare payments if you fall short, so reporting completely and accurately is crucial.

The scoring bar hasn’t moved, but the way scores are calculated and weighted means proactive work is more important than ever.

What’s Especially Important in 2025

Health Equity

CMS is making health equity a core theme, asking providers to show how they address gaps for underserved patients.
Example: Reporting on social determinants (like housing or food insecurity) and offering translation or outreach services are now rewarded through bonus points.

Telehealth & Remote Monitoring

MIPS now expects more practices to use remote care tools for chronic disease management and patient engagement.
Telehealth visits and remote patient monitoring are valued across both Quality and Cost categories, especially for improving outcomes and medication adherence.

Interoperability / Data Exchange

Technology and data sharing requirements are stricter, with a major focus on seamless, secure patient record access.
Practices need EHRs that allow real-time health information exchange, not just documentation.

Chronic Care / Outcomes

MIPS is shifting toward measuring real health improvement, not just performed services or processes.
Patient outcomes (e.g., controlling chronic conditions), readmission reduction, and preventive care now play a bigger role in scoring.

What You Should Do Now

Review your 2024 performance: Look closely at last year’s gaps and strengths to guide improvement.
Choose outcome-based quality measures: Select reporting measures that track actual patient results—not just basic tasks.
Expand health equity initiatives: Include outreach, translation, and extra support for underserved populations; these earn bonus points and strengthen compliance.
Adopt or boost telehealth/remote monitoring: Integrate virtual care and remote monitoring to support chronic disease management and improve scores.
Upgrade your EHR and tech: Ensure your systems meet current interoperability and data-sharing standards for seamless reporting and information exchange.
Create a MIPS action plan: Map out key deadlines and checklist items, like measure selection, staff training, quarterly benchmarking, and final submission timelines.

Proactive steps now mean higher scores, fewer surprises, and better patient care all year.

Be Ready for 2025 and Turn Change into Opportunity

2025 MIPS isn’t just about more reporting—it’s about working smarter, focusing on real patient outcomes, health equity, and technology to elevate care.

By acting now—reviewing last year’s performance, upgrading your tech, and targeting new bonus opportunities—you can turn these changes into practice growth, rather than scrambling to avoid penalties.

Early preparation means fewer headaches, better performance, and higher reimbursement. Start now, and use these new rules to improve both your revenue and your patient care.