Changes to the MIPS Program for PY 2024

In November of 2023, CMS released the ‘CY 2024 Medicare Physician Fee Schedule (PFS) Final Rule’, including all policy changes made to the Quality Payment Program (QPP) for the 2024 performance year. Here’s what all eligible clinicians need to know:


The most significant elements of MIPS that will NOT change include but are not limited to the following:

  • The 2024 MIPS Performance Threshold
    • The performance threshold will remain75 points – meaning a final score of 75 will still result in a neutral payment adjustment for payment year 2026. The following table shows the adjustment plan for 2024: 
2024 MIPS Final Score 2026 Payment Adjustment 
0 – 18.75 points -9% 
18.76 – 74.99 points Greater Than –9%, Less than 0% 
75 points 0% 
75.01 – 100 points Greater than 0%, Less than or Equal to +9% 

Quality Category Changes 

The following changes have been made for the Quality performance category: 

  • Clinicians must now achieve 75% ‘data completeness’ for each quality measure (changed from 70%). 
  • Total of 198 Quality Measures for PY 24 
    • Addition of 11 new quality measures 
    • Complete removal of 11 quality measures 
    • Partial removal of 3 quality measures (retained for MVP use only) 
    • Substantive changes to 58 existing quality measures. 

Improvement Activities (IA) Category Changes 

The following changes have been made to the IA performance category: 

  • Total of 106 Improvement Activities for PY24 
    • Addition of 5 new improvement activities 
    • Removal of 3 improvement activities 
    • Modification of 1 existing improvement activity 

Promoting Interoperability (PI) Category Changes 

The following changes have been made to the PI performance category: 

  • The performance period for the PI category has been extended to a minimum of 180 continuous days(changed from 90 continuous days). 
  • Automatic reweighting for the PI category will be altered for some clinician types, with some types being disqualified for reweighting, and others gaining qualification. The following chart shows which types are being altered: 
Now Disqualified Still Qualified 
Physical Therapists Clinical Social Workers 
Occupational Therapists ASC-Based Clinicians and Groups 
Qualified Speech-Language Pathologists Hospital-Based Clinicians and Groups 
Clinical Pathologists Non-Patient Facing Clinicians and Groups 
Registered Dieticians or Nutrition Professionals Clinicians in a Small Practice 

Clinicians are now required to attest “yes” for the SAFER Guide measure. 

Cost Category Changes 

The following changes are being made to the Cost performance category: 

  • CMS is updating the way they calculate the Cost category, specifically to match the scoring methodology of the Quality category. 
  • There will be a total of 29 Cost measures available in 2024.  
    • Addition of 5 new episode-based measures. 

Look out for our upcoming 2024 MIPS Overview webinar that will go into more detail on these and other changes to the MIPS program for PY2024.