Your 2025 MIPS Score Is In. Check It Before the Review Window Closes.
CMS has released final scores for the 2025 performance year, and they set your 2027 Medicare payment adjustment. Practices get one chance to challenge a scoring error, and the clock is tied to a date CMS has not announced yet.
Idea in Brief
The News
CMS has posted MIPS performance feedback and final scores for 2025. Those scores determine the payment adjustments clinicians and groups receive in 2027.
The Deadline
A targeted review window is already open. It closes 30 days after CMS releases the 2027 payment adjustments, which the agency expects in about a month.
The Move
Sign in to the QPP website now, compare the feedback with what you submitted, and file a targeted review with documentation if something is wrong. CMS decisions on those requests are final.
MIPS performance feedback is easy to ignore. The score arrives months after the reporting work is done, the number feels abstract, and the payment consequence lands a full year later. This fall is a good time to open it anyway, because the score just released is the one that sets your Medicare payment adjustment for 2027, and the window to fix a mistake in it is short.
The Centers for Medicare and Medicaid Services has released Merit-based Incentive Payment System performance feedback and final scores for the 2025 performance year, the Michigan State Medical Society reported on Oct. 1. The American Academy of Sleep Medicine also posted notice of the release. According to the Michigan society, CMS expects information on the 2027 MIPS payment adjustments to be available in approximately one month.
A review window with a moving end date
If a clinician or group believes CMS calculated its 2025 final score or its 2027 payment adjustment incorrectly, it can request a targeted review. That window opened when the final scores were released. It stays open until 30 days after CMS releases the 2027 payment adjustments, a date the agency is expected to announce through the Quality Payment Program listserv.
In practical terms, that means the deadline is not on anyone's calendar yet. A practice that waits for the adjustment notice before opening its feedback will be working against a 30 day clock. A practice that reviews its feedback now has weeks of extra room to find a problem, gather records, and file.
The deadline is not on anyone's calendar yet. Practices that wait for the payment notice will be working against a 30 day clock.
What counts as a scoring error
The Michigan society listed several examples of circumstances that may warrant a targeted review. MIPS data may have been submitted under the wrong Taxpayer Identification Number or National Provider Identifier. A clinician may hold Qualifying APM Participant status and should not be receiving a MIPS payment adjustment at all. Or performance categories may not have been automatically reweighted even though the clinician or practice qualified for reweighting because of extreme and uncontrollable circumstances.
None of these are exotic. Groups that added or lost clinicians, changed billing structures, or joined an alternative payment model during 2025 have particular reason to compare what they believe they reported with what CMS scored.
CMS generally requires supporting documentation with a targeted review request, though what is needed depends on the circumstances, and a CMS representative will contact the requester if more information is required. If CMS approves a request that changes the score, it will update the final score and, where applicable, the payment adjustment as soon as technically feasible. One caution matters more than the rest: CMS targeted review decisions are final and are not eligible for further review. A thin request is a wasted request.
Clinical Pearls
- Pull your 2025 performance feedback this week rather than waiting for the payment adjustment notice.
- Confirm the data sits under the correct TIN and NPI for every clinician and group you reported.
- If anyone in the group holds Qualifying APM Participant status, make sure they are not slated for a MIPS adjustment.
- If you qualified for extreme and uncontrollable circumstances reweighting, check that the reweighting was actually applied.
- Gather supporting documentation before you file, because CMS generally requires it and its targeted review decisions cannot be appealed further.
- Watch the QPP listserv for the announcement that 2027 payment adjustments are available, since that date starts the final 30 days.
How to file
Feedback and targeted review both live on the Quality Payment Program website. Clinicians and groups sign in with their Health Care Quality Information Systems Access Roles and Profile credentials, known as HARP, which are the same credentials used to submit 2025 MIPS data. Once signed in, the targeted review option appears in the left-hand navigation.
If the person who submitted your data has left the practice, solve the access problem first. Recovering credentials can take longer than the review itself.
The bigger shift behind the score
This cycle also arrives as CMS considers the future of MIPS itself. The 2027 Medicare Physician Fee Schedule proposed rule includes proposals related to transitioning away from traditional MIPS and toward MIPS Value Pathways reporting beginning in 2029, according to the Michigan society. CMS is gathering input through an MVP Adoption Survey open to practices at every stage, from those that reported an MVP for 2025 to those that have not started. Participation is voluntary and confidential, results go to CMS in aggregate, and eligible clinicians may be able to receive improvement activity credit for completing it.
The same proposed rule, published July 16, would lower the 2027 conversion factor by 1.19 percent to $33.17 for qualifying alternative payment model participants and by 1.68 percent to $32.84 for other physicians and practitioners, AJMC reported. The sleep medicine academy, which opposed the cuts in its comments, tied them to the expiration of a temporary 2.5 percent increase for 2026 and said it expects a final rule in late October or early November.
Neither the score nor the fee schedule is fully in a practice's control. The accuracy of the score is. An hour with the feedback report this month is cheap insurance on a year of Medicare payments.
Priya Natarajan has run operations for multispecialty groups and writes The Script Pad's practice management column.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
