MIPS 2025 reporting: 3-step guide

Exemption reweighting is unchanged in 2025. Below is the breakdown of the 2025 MIPS category weights and how the weights will be redistributed if various exemptions are applied.

As a refresher, here are the baseline weights for 2025:

• Quality: 30%

• Cost: 30%

• Promoting Interoperability (PI): 25%

• Improvement Activities (IA): 15%

Small practices (15 providers or fewer)

CMS automatically reweights the Promoting Interoperability performance category for clinicians in small practices. If only PI is reweighted, the 25% category weight will be split between Quality and Improvement Activities:

• Quality: 40%

• Cost: 30%

• IA: 30%

Cost

If the clinicians within the small practice choose to report on PI, and only Cost is reweighted, the 30% Cost category weight will be split between Quality and PI:

• Quality: 55%

• IA: 15%

• PI: 30%

PI and Cost

If both Cost and PI are reweighted, there will be a split between Quality and Improvement activities to:

• Quality: 50%

• IA: 50%

Large practices (16 providers or more)

PI

For large practices, if PI is the only category reweighted, the 25% category weight will be redistributed to Quality:

• Quality: 55%

• Cost: 30%

• IA: 15%

Cost

If Cost is the only category reweighted, the 30% weight will be split between PI and Quality:

• Quality: 55%

• IA: 15%

• PI: 30%

PI and Cost

If both Cost and PI are reweighted, the weights will be added to Quality:

• Quality: 85%

• IA: 15%

Next steps

See the Academy’s MIPS resources for more information.

Related Academy resources

Disclaimer: The information contained in this resource has been developed as educational and reference materials, and is not intended to be legal or accounting advice. Every effort has been made to represent information that is current and accurate. As CMS continues updating the MACRA program, details in this assessment may change. The content within this resource has not been endorsed by CMS nor any other regulatory body. Users are advised that this resource does not replace or supersede local or state laws. This resource is not a substitute for attorney advice regarding your own practice's policies and legal compliance with applicable statutes. The Academy disclaims any liability arising out of the use of this resource or for any adverse outcome from the application of this information for any reason, including but not limited to the reader's misunderstandings or misinterpretations of the information contained within this resource. The information in this resource should not serve as a substitute for consulting with an attorney or other experts.