Quality Payment Program Small Practices Newsletter: August 2025
Quality Payment Program Small Practices Newsletter: August 2025
The Quality Payment Program (QPP) Small Practices Newsletter is a monthly resource that provides small practices (15 or fewer clinicians) with program updates, upcoming QPP milestones, and resources to support their continued participation and success in QPP. The newsletter is disseminated on the second Tuesday of each month.
Please share this newsletter with your fellow clinicians and practice staff and encourage them to sign up to receive this monthly resource.
At-a-Glance: Required and Recommended Activities for Successful Participation in QPP
Each month, we share required and recommended activities for small practices to support their successful participation in QPP. The activities follow a rolling quarter approach, letting you see activities for the previous month, the current month, and the following month.
There was a delay with receiving some of the final Medicare claims data needed to calculate cost measures. As a result, MIPS final scores for the 2024 performance year won’t be published until the fall, at which point we’ll also open the Targeted Review period. MIPS payment adjustments for the 2026 MIPS payment year will be released approximately one month after the release of final scores. The Targeted Review period will close 30 days after the release of MIPS payment adjustments. You’ll continue to be able to access measure and activity-level scores for the data you reported during the submission period. However, performance period benchmarks are part of final scoring and won’t be available until final scores are released.
We recognize that this is a change from the timeline we previously communicated and apologize for the inconvenience. We will communicate more definitive information about the revised timeline as we have it. In the meantime, we encourage you to confirm your MIPS eligibility and review the following scoring resources so that you’re prepared to understand your scores when they’re released. To confirm your eligibility for a MIPS payment adjustment, enter your National Provider Identifier (NPI) on the QPP Participation Status Look Up Tool (check “PY 2024”) or sign into the QPP website and navigate to the Eligibility & Reporting page on the left hand navigation. Review pages 12 – 16 of the 2024 MIPS Eligibility and Participation Guide (PDF, 1MB) for more information about what you see.
The Notice of Proposed Rulemaking (NPRM) includes proposals for MIPS and Advanced Alternative Payment Models (APMs), as well as several Requests for Information (RFIs).
Specifically, we’re proposing policies that:
Continue the development and maintenance of MIPS Value Pathways (MVPs).
Establish the APM Performance Pathway (APP) Plus quality measure set.
Update the MIPS measure/activity inventories and scoring methodologies.
Finally, we’re proposing a small number of policies intended to maintain stability within the MIPS program through the established performance threshold and data completeness criteria.
2026 Policy Highlights
Key QPP policies that we are proposing in the CY 2026 PFS Proposed Rule include:
Introducing 6 new MVPs for the 2026 performance year that are related to diagnostic radiology, interventional radiology, neuropsychology, pathology, podiatry, and vascular surgery.
Allowing multi-specialty small practices to continue reporting MVPs at the group level. (i.e., not requiring multispecialty small practices that want to report an MVP to do so at the individual or subgroup level)
Introducing a 2-year informational-only feedback period for new cost measures, allowing clinicians to receive feedback on their score(s) and find opportunities to improve performance before a new cost measure affects their MIPS final score.
Maintaining the current performance threshold policies, leaving the performance threshold set at 75 points through the 2028 performance year.
Introducing Qualifying APM Participant (QP) determinations at the individual level, in addition to existing determinations at the APM entity level.
Learn more about the QPP proposals by reviewing the following 2026 QPP Proposed Rule Resources:
Regular mail– You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS‑1807-P, P.O. Box 8016, Baltimore, MD 21244-8016. Please allow sufficient time for mailed comments to be received prior to the end of the comment period.
Express or overnight mail– You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1807-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244‑1850.
Please note: FAX transmissions won’t be accepted.
The 60-day comment period for the 2025 PFS Proposed Rule is open until 5 p.m. ET on September 12, 2025.
For More Information
Learn more about the QPP proposals by reviewing the following QPP policies in the CY 2026 Medicare PFS Proposed Rule Resources:
On July 3, the Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool based on the first snapshot of Alternative Payment Model (APM) data. The first snapshot includes data from Medicare Part B claims with dates of service between January 1, 2025, and March 31, 2025.
The tool includes 2025 Qualifying APM Participant (QP) status and Merit-based Incentive Payment System (MIPS) APM participation status.
To learn more about how CMS determines QP and the APM participation status for each snapshot, please visit the QPP website.
What Action Do I Need to Take?
Log into the QPP Portal and verify your Entity information.
If your information is inaccurate on the QPP website, contact the QPP helpdesk at QPP@cms.hhs.gov.
In response to the Texas severe storms, straight-line winds, and flooding, as identified by both the Health and Human Services (HHS) Public Health Emergency (PHE) declaration (Texas) and Federal Emergency Management Agency (FEMA) disaster declaration (DR-4879-TX), the Centers for Medicare & Medicaid Services (CMS) has determined that the MIPS automatic EUC policy will apply to MIPS eligible clinicians in the designated affected counties of Texas for the 2025 performance period.
MIPS eligible clinicians in these areas will be automatically identified and have all 4 performance categories reweighted to 0% during the data submission period for the 2025 performance period (January 2 to March 31, 2026). This will result in a score equal to the performance threshold, and they'll receive a neutral payment adjustment in the 2027 MIPS payment year.
MIPS eligible clinicians in these areas who choose to submit data on 2 or more performance categories will be scored on those performance categories and receive a 2027 MIPS payment adjustment based on their 2025 MIPS final score. (Categories for which data isn’t submitted won’t be scored.)
NOTE: The MIPS automatic EUC policy doesn’t apply to MIPS eligible clinicians participating in MIPS as a group, subgroup, virtual group, or Alternative Payment Model (APM) Entity.
Groups, virtual groups, and APM Entities can request reweighting through the EUC Exception application.
Subgroups will inherit any reweighting approved for their affiliated group; they can’t request reweighting independent of their affiliated group’s status.
Share your feedback on what you like most about the Small Practices Newsletter, what can be improved, and/or what topics you would like to see addressed. Please include “Small Practices Newsletter” in the email subject line.
Contact the QPP Service Center by email at QPP@cms.hhs.gov, by creating a QPP Service Center ticket, or by phone at 1‑866‑288‑8292 (Monday – Friday, 8 a.m. – 8 p.m. ET).
To receive assistance more quickly, please consider calling during non-peak hours — before 10 a.m. ET and after 2 p.m. ET.
People who are deaf or hard of hearing can dial 711 to be connected to a Telecommunications Relay Services (TRS) Communications Assistant.
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