Calculating the Final Score Under MIPS

For 2023, the MIPS final score (or the Composite MIPS score) is calculated as the sum Quality (30%) + PI (25%) + IA (15%) + Cost (30%). Additionally, the Complex Patient Bonus (upto 5 points) will be added to the MIPS Final Score and based on the overall medical complexity and social risk for the patients treated by a provider or group

For 2023, the MIPS performance threshold has been increased from 60 to 75 points. Eligible providers/practices need a minimum score of 60 to avoid negative payment adjustment. Additional performance threshold is set at 89 points for exceptional performance.

Final Score

Clinician Quality performance category score x actual Quality performance category weight

+

Clinician Cost performance category score x actual Cost performance category weight

+

Improvement Activities performance category score x actual Improvement Activities performance category weight

+

Promoting Interoperability performance category score x actual Promoting Interoperability performance category weight

x

100

MIPS Final score and Payment adjustment:

MIPS Final Score will be between 0 and 100 points. Each final score will correlate to a payment adjustment(s).

Calculating the Final Score Under MIPS

MIPS 2023: Payment Adjustment