MIPS 2025 reporting: 3-step guide
Step 3: Small and large practice reporting options
Access the PDF
See a PDF version of the Academy’s practice reporting options.
Review these reporting options for small practices (15 providers or fewer) and large practices (16 providers or more) to help achieve the minimum and maximum points needed to either avoid the penalty or achieve an incentive. These are not exhaustive as there may be other combinations of reporting that can help achieve the desired outcome.
Small practice: Avoiding the 9% penalty with an EHR
Achieving between 75.01-100 points will earn a positive payment adjustment based on a sliding scale determined by CMS.
QUALITY (30%) | IA (15%) | PI (25%) | COST (30%) | TOTAL |
|---|---|---|---|---|
Report 6 quality measures with a maximum of 10 points each for all eligible encounters in 2024, PLUS 6 bonus points automatically added to the numerator for small practices. Note, you can report more than 6 measures and CMS will count the highest-scoring ones. 33 points | Attest to 1 IA (for at least 90 consecutive days in 2025). 15 points | Report 6 or 7 PI measures from each of the 4 objectives for all eligible encounters (for at least 180 consecutive days in 2025). 25 points | CMS will automatically assess and add a maximum of 30 points to your final MIPS score. If you are exempt from Cost, it will be reweighted between Quality (55%) and PI (30%). Up to 30 points | 73 points + up to 30 points for Cost (if max points added) |
Small practice: Avoiding the 9% penalty with the automatic PI exemption
Achieving between 75.01-100 points will earn a positive payment adjustment based on a sliding scale determined by CMS.
QUALITY (40%) | IA (30%) | PI (0%) | COST (30%) | TOTAL |
|---|---|---|---|---|
Quality category reweighted to 40%. Report 6 measures with a maximum of 10 points for all eligible encounters in 2025, PLUS 6 bonus points automatically added to the numerator for small practices. Note, you can report more than 6 measures and CMS will count the highest-scoring ones. 44 points | IA category reweighted to 30%. Attest to 1 IA (for at least 90 consecutive days in 2025). 30 points | Exempt. CMS reweights PI to Quality. | CMS will automatically assess and add a maximum of 30 points to your final MIPS score. If you are exempt from Cost, it will be reweighted to Quality (50%) and IA (50%). Up to 30 points | 74 points + up to 30 points for Cost (if max points added) |
Exemptions
See more Academy analysis of PI exemptions.
Small practice: Avoiding the 9% penalty with PI and Cost exemptions (non-EHR)
Achieving between 75.01-100 points will earn a positive payment adjustment based on a sliding scale determined by CMS.
QUALITY (50%) | IA (50%) | PI (0%) | COST (0%) | TOTAL |
|---|---|---|---|---|
Quality category reweighted to 50%. Report up to 6 measures that total at least 24 points, PLUS 6 bonus points automatically added to the numerator for small practices. Note, you can report more than 6 measures and CMS will count the highest-scoring ones. 25 points | IA category reweighted to 50%. Attest to 1 IA (for at least 90 consecutive days in 2025). 50 points | Exempt. CMS reweights PI to Quality and IA. | If CMS determines you are exempt from the Cost category, this category’s weight will be redistributed to Quality and IA, making each 50%. | 75 points or more |
Exemptions
See more Academy analysis of PI exemptions.
Large practice: Avoiding the 9% penalty with an EHR
Achieving between 75.01-100 points will earn a positive payment adjustment based on a sliding scale determined by CMS.
QUALITY (30%) | IA (15%) | PI (25%) | COST (30%) | TOTAL |
|---|---|---|---|---|
Report 6 quality measures with a maximum of 10 points each for all eligible encounters in 2025.Note, you can report more than 6 measures and CMS will count the highest-scoring ones. 30 points | Attest to 2 IAs (for at least 90 consecutive days in 2025). 15 points | Report 6 or 7 PI measures from each of the 4 objectives for all eligible encounters (for at least 180 consecutive days in 2024).
25 points | CMS will automatically assess and add a maximum of 30 points to final MIPS score. If exempt from Cost category, 30% weight applied to PI category. Up to 30 points | 70 + up to 30 more for Cost (if max points added) |
Next steps
See the Academy’s MIPS resources for more information.
Use our online form to contact practice management staff with questions or concerns.
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.
