A slightly greater percentage of Quality Payment Program (QPP) participants will receive positive payment adjustments this year due to overall better scores during the 2023 performance year, according to a recent QPP Participation and Performance Results report.
The annual report tracks participation in each of the QPP reporting pathways – the traditional Merit-Based Incentive Payment System (MIPS), the MIPS Value Pathway (MVP), and alternative payment models (APMs), sharing performance results in the areas of quality, cost, interoperability, and improvement activities.
The report established that overall, 80.86% of MIPS-eligible clinicians scored above the 75% performance threshold needed to avoid a negative adjustment. In 2022, 79% of participants scored above the same performance threshold. They will see positive adjustments of up to 2.15% in their 2025 Medicare payments.
Conversely, 2.26% of participants will receive the maximum 9% penalty applied to 2025 Medicare payments, slightly up from 2% the year before. The percentage of physicians receiving a less severe negative payment adjustment (of no more than 6.75%) was also up just slightly, from 12% in 2022 to 12.3% in 2023.
The overall mean score of 83.2 improved slightly between the 2022 and 2023 reporting periods. The mean for participants reporting through MVPs was 87.86 points – five points higher than traditional MIPS reporting, with those reporting via the APM Performance Pathway outperforming all other groups with an average score of 94.4.
“MIPS is required by law to be a budget-neutral program, which generally means that the projected negative adjustments must be balanced by the projected positive adjustments,” the Centers for Medicare & Medicaid Services (CMS) said in its report. “When more clinicians receive a negative payment adjustment, clinicians with a positive payment adjustment see a larger payment adjustment amount.”
Texas Medical Association staff remind physicians participating in MIPS to be mindful of the Dec. 31 deadline for two hardship exceptions, as well as recent changes CMS made in the improvement activities category, eliminating eight of the 104 options in May.
Physicians can also preview their 2023 QPP scores through June 25 at 7 p.m., providing corrections or appealing as needed before they’re made publicly available on the Care Compare section of the Medicare.gov site, for consumers wishing to compare a variety of Medicare physicians and facilities, and on the Provider Data Catalog, where visitors can download and access physicians’ MIPS performance scores and improvement activities.
Learn more about TMA’s Medicare payment reform advocacy, and sign up for CME covering this year’s Medicare Physician Fee Schedule.
Last Updated On
June 23, 2025
Originally Published On
June 23, 2025
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.