Changes to the Performance Categories for MIPS 2023 

We previously discussed the MIPS 2023 performance year timeline, as well as the performance threshold and payment adjustments for the new year. Now, we will go over the specific changes being made to the performance categories for MIPS 2023. 

Quality Performance Category

  • Quality Performance represents 30% of your final score, with 60 total category points available 
  • Performance Period is still Jan 1 – Dec 31 of this year 
  • Clinician must report on 6 individual measures 
    • At least 1 outcome OR high priority measure 
    • Small practice bonus of 6 points 
  • 70% data completeness required
Changes for 2023: 
  • Total of 198 quality measures for PY23 
  • Addition of 9 quality measures 
  • Removal of 11 quality measures 
  • Substantive changes to 76 measures 
  • Addition/Removal of measures from specialty sets 
  • Revisions to scoring benchmarks 

Promoting Interoperability (PI) Performance Category

  • PI performance represents 25% of your final score, with 100 total category points available 
  • Continuous 90-day minimum performance period during the PY 
  • Practices must complete Conduct Security Risk Analysis (SRA) and High Priority Practice Guide (SAFER Guide) annually 
  • Automatic reweighting for small practices and select clinician types 
Changes for 2023: 
  • You must use 2015 Edition Cures Update Certified EHR Technology (CEHRT) for all PY23 
  • Updated measure scoring with 5 bonus points available 
  • Query of Prescription Drug Monitoring Program (PDMP) measure is now required: 
    • 10 points available 
    • Exclusions Added 
    • Expanded scope of measure to include Schedules III and IV drugs 
  • Third option added for satisfying the Health Information Exchange (HIE) objective 
    • Enabling Exchange under the Trusted Exchange Framework and Common Agreement (TEFCA) 
  • Modified levels of active engagement for the Public Health and Clinical Data Exchange Objective 
    • Combine Options 1 and 2 
    • Required to submit active engagement level 
This graphic shows the updates objectives and measures for the PI Performance Category: 

Improvement Activities (IA) Performance Category

  • IA performance represents 15% of your final score, with 40 total category points available 
  • Continuous 90-day minimum performance period during the PY 
  • Activity Weights: 
    • High = 20 points 
    • Medium = 10 points 
  • Small practices receive double-weighting 
  • Groups can attest when at least 50% of clinicians perform the same activity
New for 2023: 
  • 100+ total improvement activities for PY23 
  • Addition of 4 improvement activities 
  • Removal of 6 improvement activities 
  • Modification of 5 improvement activities 

Cost Performance Category

  • Cost performance represents 30% of your final score 
  • Performance Period is still Jan 1 – Dec 31 of this year 
  • Measures 
    • Medicare Spending Per Beneficiary (MSPB) 
    • Total Per Capita Cost (TPCC) 
    • 23 episode-base measures 
  • No reporting requirement; data pulled from administrative claims and calculated by CMS
New for 2023: 
  • Establishing a maximum cost improvement score of 1 percentage point 
    • All MIPS eligible clinicians will receive a cost improvement score of 0 for PY22 

Please keep in mind that the changes for PY23 DO NOT affect your MIPS submission for PY22, which should be submitted to HCIS by March 15. For more information about MIPS 2022 reporting, please view our webinar about Success in Quarter 4