The Centers for Medicare & Medicaid Services (CMS) has issued its Calendar Year (CY) 2025 Medicare Physician Fee Schedule (PFS) Final Rule, which includes policies for the Quality Payment Program (QPP) for the 2025 performance year (PY) and beyond. This rule will be published on December 9, 2024, in the Federal Register.
2025 Policy Highlights
Below are some of the key QPP policies that CMS finalized:
Merit-based Incentive Payment System (MIPS) (General)
We finalized policies for the 2025 performance period for the MIPS performance categories, which includes:
- The addition of 7 new quality measures, substantive changes to 66 quality measures, and the removal of 10 quality measures.
- Changes to our cost measure scoring methodology.
- The removal of the 7-point cap for scoring certain topped out quality measures in specialty sets with limited measures.
- The addition of 6 new episode-based cost measures and modifications to 2 existing episode-based cost measures.
- Updates to our policy governing our treatment of multiple data submissions received for the Promoting Interoperability performance category.
- The removal of improvement activity weighting and streamlining the reporting requirements for the performance category.
- The finalization of a minimum criteria for a qualifying data submission (i.e., eligible for scoring) in the quality, improvement activities, and Promoting Interoperability performance categories.
Maintaining Stability in MIPS
- We maintained the current performance threshold policies, leaving the MIPS performance threshold set at 75 points for the 2025 performance period.
- We finalized keeping the 75% data completeness criteria through the 2028 performance period.
MVP Development and Maintenance
- We finalized 6 new MVPs for the 2025 performance period that are related to ophthalmology, dermatology, gastroenterology, pulmonology, urology, and surgical care.
- We finalized limited modifications to the previously finalized MVPs, including the consolidation of 2 neurology-focused MVPs into a single neurological MVP.
APP Plus Quality Measure Set
- We finalized, with modification, an additional quality measure set under the APP called the APP Plus quality measure set. It will be comprised of 11 measures, consisting of the 6 measures in the existing APP quality measure set, 5 of which are Adult Universal Foundation measures, and 5 additional measures from the Adult Universal Foundation measure set. These measures will be incrementally incorporated over time, more gradually than originally proposed.
Overview of QPP Policies in the CY 2025 Medicare PFS Final Rule – Webinar Details
CMS will host a webinar on November 14 to provide an overview of the final policies for the 2025 performance year. During this webinar, CMS will answer questions from attendees, as time permits. Register for this event.
For More Information
Learn more about the CY 2025 Medicare PFS Final Rule and QPP policy changes by reviewing the following resources:
- 2025 QPP Policies Final Rule Fact Sheet (PDF, 2MB) – Provides an overview of QPP policies in the CY 2025 Medicare PFS Final Rule, and a comparison table showcasing the changes to current QPP policies.
- 2025 Finalized MIPS Value Pathways Guide (PDF, 3MB) – Highlights the finalized MVP policy changes, beginning with the 2025 performance year.