2025 MIPS final scores: What to check and when to request a Targeted Review
CMS has released the 2025 MIPS final scores and Performance Feedback. The 2025 MIPS final score determines the Medicare payment adjustment that will apply in 2027. This payment adjustment information is not available yet. CMS expects to release it within a month.
Providers and provider organizations should review their 2025 MIPS final scores in the QPP Portal now and check for any issues.
EHRs that support MIPS should also be prepared for questions from customers reviewing their final scores.
This blog explains what to check, what could indicate an error, and when a Targeted Review should be considered.
How to check the 2025 MIPS final score in the QPP Portal
Providers and provider organizations can sign in to the CMS QPP Portal using their Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) credentials.
Click “View Feedback”, select the organization, and review:
2025 MIPS final score
Performance category scores
MIPS eligibility and participation information
MIPS Performance Feedback
Note: If the account has not been used recently, check that the login and organization access still work. Reset the password if needed.EHRs supporting MIPS customers: Third-party representatives cannot access providers’ final Performance Feedback or payment adjustment information. The provider or provider organization’s authorized representative must access this information through the QPP portal.
Check if the MIPS final scores match the MIPS submission
Compare the 2025 MIPS final score with the information submitted to CMS in the final submission. Check for any discrepancies, such as:
Submitted data does not reflect correctly in the final MIPS score
Submitted data is associated with the wrong TIN or NPI
MIPS eligibility applied incorrectly
A special status (like small practice) that is not applied correctly
An approved hardship exception or reweighting that was not applied
NOTE: Exceptions and special statuses can affect MIPS reporting requirements and final scoring.EHRs that supported 2025 MIPS reporting may also get questions from their customers after they check their MIPS final scores. Preparing the customer support team to handle these questions will help boost customer satisfaction.
Financial impact of 2025 MIPS score in 2027
A provider's 2025 final score determines how payments to Medicare Part B-covered professional services will be adjusted from Jan. 1, 2027, to Dec. 31, 2027.
2025 MIPS final score and associated 2027 payment adjustment
Above 75 points: Positive payment adjustment (up to +9%)
75 points: Neutral payment adjustment (0)
Below 75 points: Negative payment adjustment (up to -9%)
Note: The actual payment adjustment depends on CMS’ budget-neutral calculations.CMS has indicated that it will make the 2027 MIPS payment adjustment information available in approximately one month (Oct end).
When should a Targeted Review be considered?
A Targeted Review allows a provider or provider organization to request CMS to review a suspected error in the final MIPS score. It enables providers to request this review based on a specific error suspected in their MIPS final score calculation, not simply because the score is lower than expected.
If a provider or provider organization identifies a discrepancy during their score review (as outlined above), they must first determine if a Targeted Review is appropriate and gather the information needed to support the request.
The Targeted Review period will be open for approximately 60 days. It opens with the release of MIPS final scores and closes 30 days after the release of MIPS payment adjustments.
Note: CMS has established that decisions resulting from a MIPS Targeted Review are final, with no further review or appeal.What information is required for a Targeted Review?
The information needed depends on the issue. CMS may ask for documentation that supports the reason for the Targeted Review. This could include:
Submission records, including receipts, confirmation records, and measure-level results
MIPS eligibility information and NPI records
Exception or reweighting approvals
CMS Performance Feedback
Other records that show the identified discrepancy
Start with the specific issue, then gather the records that support it.
Need help with Targeted Review?
If you identify a potential error in your 2025 MIPS scores, Darena Health can help assess the issue and support you through the CMS Targeted Review process.
To get started with the Targeted Review, we will need:
CMS Performance Feedback for the applicable performance year
Details about the issue or discrepancy you identified
Relevant supporting documentation that may help validate the issue
Organization and NPI information for the clinicians or entities affected
We will review the information, assess the discrepancy, and help determine the appropriate next steps for a Targeted Review.
Targeted Review support is a separate paid service. Pricing depends on the scope and complexity of the review, including the organization structure and number of NPIs involved.
Simplify MIPS 2026 with MyMipsScore
Darena Health has supported EHRs and provider organizations with MIPS since the program began and has been a CMS Qualified Registry since 2017.
MyMipsScore brings that experience into one platform to track performance, manage reporting, and submit to CMS for multiple specialties and locations.
