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CMS QPP MIPSCMS Quality Payment Program (MIPS)
U.S. Centers for Medicare and Medicaid Services · Tier-2 · profile-enrichment (renders on matched profiles)
The CMS Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) publishes annual composite performance scores for individual clinicians and group practices participating in Medicare Part B. Scores (0–100) span four performance categories — Quality, Cost, Improvement Activities, and Promoting Interoperability — and determine a payment adjustment (positive, neutral, or negative) applied to Medicare reimbursements two years after the performance year.
How this source shows up on Fonteum.
Loaded PY2023 MIPS composite scores can render on NPI-matched provider profiles with source and performance-year metadata. The loaded table has no populated per-clinician payment-adjustment percentage, so Fonteum does not display one. Data is surfaced as published by CMS; Fonteum does not independently score, weight, or rank clinicians.
What this source does NOT mean
MIPS scores are a Medicare reimbursement-program measure, not a comprehensive measure of clinical quality or patient outcomes. A high MIPS score indicates participation and performance on program-defined measures; it does not evaluate all dimensions of care. Clinicians who opt out, are excluded, or fall below the low-volume threshold are not scored.
Research and data questions this source supports.
- Surface a clinician's composite MIPS score on their provider profile as the first federal quality signal beyond Medicare enrollment.
- Build a specialty-filtered MIPS leaderboard — identify the top-performing cardiologists in a metro by their composite performance score.
- Support payer credentialing with QPP MIPS individual scores as a quality tier signal alongside board certification and PECOS enrollment.
- Run specialty-level quality distributions to benchmark a practice against national and state peer cohorts.
- Power a research surface showing how MIPS composite-score distributions vary by specialty and performance year.
Dataset size: 477,137 clinician scores (Performance Year 2023)
Per-field display contract.
Fields listed below show their configured `display_allowed` flag from the §94 provenance schema. Fields marked write-locked are captured for audit and are not rendered on profile pages.
Renders on profile
8 fieldsWhat we can’t infer from this source.
- Annual cadence — scores lag performance year by ~12 months (performance year 2024 scores publish ~July 2025).
- ~30% of eligible clinicians excluded or opted out (low-volume threshold, voluntary opt-out, newly enrolled providers).
- Group scores cover practice aggregate, not individual clinician performance within the group.
- MIPS measures change year-to-year; scores are not directly comparable across performance years without cohort flagging.
- Payment adjustment applies to Medicare Part B reimbursements only; no direct bearing on commercial-insurance quality.
Authority, license, publisher cadence.
Authority
U.S. Centers for Medicare and Medicaid Services
Tier
Tier-2 · profile-enrichment (renders on matched profiles)
Publisher / configured cadence
Declared or configured cadence: Annual (July, post-performance-year scoring). Not evidence of the latest loaded source date.
License
U.S. government public-domain works (17 U.S.C. § 105). Attribution required: 'Source: CMS QPP MIPS · Performance Year {YYYY}'. License ↗
Official URL
Attribution requirement
Source: CMS QPP MIPS · Performance Year {YYYY} · Last checked {YYYY-MM-DD}
What the source allows.
U.S. government public-domain works (17 U.S.C. § 105). CMS publishes QPP participation and performance data at qpp.cms.gov and data.cms.gov with explicit redistribution rights. Attribution must include the performance year.
What a single field looks like in the graph.
This worked example shows the provenance shape used when a surfaced field has populated source, last-checked, display-rule, and confidence metadata. Individual fields may omit unavailable values.
Field
MIPS final composite score (profile)
Sample value
Final score: 82.5/100 · Above 75-point threshold · PY2023 · NPI 1063717142
Provenance line
Source: CMS QPP MIPS · Performance Year 2023 · Methodology cms-qpp-mips/v1 · Display rule: per-clinician final_score renders on provider profile with performance year inline
Official API, bulk download, and Fonteum endpoints.
Official API / download
Bulk download
Fonteum surface
Common questions about CMS QPP MIPS.
- What is the CMS QPP MIPS score and how is it calculated?
- The Merit-based Incentive Payment System (MIPS) is CMS's value-based payment program for eligible clinicians under the Quality Payment Program (QPP). A composite MIPS score (0–100) is calculated across four performance categories: Quality, Improvement Activities, Promoting Interoperability, and Cost. For Performance Year 2023, the threshold was 75 points: scores above 75 received a positive adjustment, a score of 75 was neutral, and scores below 75 received a negative adjustment. The exceptional-performance bonus ended after Performance Year 2022.
- Where can I download the QPP MIPS individual clinician data?
- CMS publishes annual QPP MIPS individual and group performance data at qpp.cms.gov. The public dataset is available for download as a CSV file. Fonteum's loaded Performance Year 2023 individual table contains 477,137 clinician-score rows.
- What is the national average MIPS composite score?
- For Performance Year 2023, the national mean composite MIPS score across all participating clinicians is 83.06 and the median is 85.49, per the Fonteum MIPS Score Distribution by Specialty 2023 study. Approximately 85.5% of participating clinicians scored 75 or higher. See the full methodology at fonteum.com/research.
- Did Performance Year 2023 include an exceptional-performance bonus?
- No. The exceptional-performance bonus ended after Performance Year 2022. For Performance Year 2023, the MIPS performance threshold was 75 points: scores above 75 received a positive adjustment, a score of 75 was neutral, and scores below 75 received a negative adjustment.
- Does a high MIPS score mean a clinician is a better doctor?
- A MIPS composite score reflects participation in CMS reporting programs and performance on CMS-defined measures — it is an administrative payment-adjustment metric, not an independent clinical quality rating. Fonteum's loaded PY2023 rows expose the CMS-published score and performance year; they do not contain a populated payment-adjustment field or a deterministic source-snapshot link.
Where this source already shows up.
Related sources in the graph
- /sources → The generated source-catalog subset — documented datasets Fonteum cites.
- /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
- /methodology → Documented sourcing, publisher cadence, observed freshness, and corrections policy.
- /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.