Where Will Your MIPS Score Actually Land?
Your MIPS final score is four category scores multiplied by weights — but the weights aren’t fixed. When CMS reweights Cost or Promoting Interoperability, the points move to other categories. This estimator shows your weights, your projected score, and which category is worth the most to improve.
- 2026 category weights, with CMS redistribution built in
- Presets for primary care, small practices, and radiology
- The single category that adds the most points
Runs entirely in your browser — nothing you enter is stored or sent anywhere.
Build your final score
Practice size
Cost scored?
PI scored?
Your category weights
Improvement activities completed
Projected MIPS final score
74.6 / 100
Below 75 points. Projected penalty: -0.05% on Part B payments two years from now.
Points still available
Category performance is the percentage of available points you earn in each category. Small practices get the small-practice bonus applied to Quality automatically here. Facility-based scoring, complex-patient bonus, and MVP reporting can change your actual final score.
How It Works
Weights Move — and That Changes Your Strategy
In 2026, traditional MIPS weights Quality at 30%, Cost 30%, Improvement Activities 15%, and Promoting Interoperability 25%. When a category can’t be scored — no attributed cost measures, or PI reweighted for non-patient-facing, hospital-based, small-practice, or hardship status — CMS redistributes its weight. A large non-patient-facing group with neither Cost nor PI ends up with Quality at 85% of the final score.
The formula
Final score = Σ (Category weight × Category performance %)
The performance threshold is 75 points through at least the 2028 performance year. Scores below 75 receive a negative adjustment of up to −9%, applied two years later.
Default
Spread the effort
With all four categories scored, no single category dominates. Quality and Cost carry the most weight, and PI is often the easiest to max out with a certified EHR.
Non-patient-facing
Quality is everything
Radiologists, pathologists, and other non-patient-facing clinicians often have PI reweighted and no cost measures. Quality then carries 85% (large practices) — so measure selection and data completeness decide the score.
Small practices
Bonus and balance
Practices of 15 or fewer get a small-practice bonus added to Quality and different redistribution: without Cost and PI, Quality and IA split the score 50/50.
MIPS category weights after reweighting (traditional MIPS)
| Scenario | Quality | Cost | IA | PI |
|---|---|---|---|---|
| All categories scored | 30% | 30% | 15% | 25% |
| No Cost | 55% | 0% | 15% | 30% |
| No PI — large practice | 55% | 30% | 15% | 0% |
| No PI — small practice | 40% | 30% | 30% | 0% |
| No Cost, no PI — large | 85% | 0% | 15% | 0% |
| No Cost, no PI — small | 50% | 0% | 50% | 0% |
From CMS’s published redistribution policy; confirm against the current QPP final rule for your performance year.
Questions
Frequently Asked Questions
What MIPS score do I need to avoid a penalty?
75 points. CMS has held the performance threshold at 75 through at least the 2028 performance year. Below 75, the negative adjustment scales up to −9%; above 75, adjustments are positive but budget-neutral.
How do I know if my PI category will be reweighted?
Check your eligibility status on the QPP Participation Status Tool. Non-patient-facing, hospital-based, ambulatory surgical center-based, and small-practice clinicians are reweighted automatically; others can apply for a hardship exception.
What does “category performance %” mean?
The share of available points you earn in that category. For Quality, that’s your measure achievement points divided by the points available (usually 60 for six measures). For IA, it’s whether you completed the required activities.
How many improvement activities do I need?
Since 2025, activities are no longer weighted. Most clinicians attest to two; clinicians with small-practice, rural, HPSA, or non-patient-facing status attest to one. MVP participants attest to one.
Does this include facility-based scoring?
No. Facility-based clinicians can receive Quality and Cost scores derived from their hospital’s Value-Based Purchasing performance when that is higher. It’s worth checking — it can beat a reported score.
Is traditional MIPS going away?
CMS has proposed sunsetting traditional MIPS after the 2028 performance year, with clinicians reporting through MIPS Value Pathways (MVPs) from then on. It’s a proposal, not final — but it’s the direction of travel.
Sources
- [1]CMS Quality Payment Program — MIPS scoring
- [2]CMS QPP — Participation Status Tool
- [3]American Academy of Ophthalmology — 2026 MIPS roadmaps (category redistribution table)
- [4]CMS — CY 2027 Physician Fee Schedule proposed rule fact sheet
This is an independent planning tool built by MedVersify from published methodology. It is not an official CMS, payer, or clinical tool, and results are estimates — confirm decisions against your own reports, payer contracts, and clinical judgment.
Keep Going
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The four performance categories, how scoring works, and the strategies that maximize your adjustment.
Read the guideMIPS Penalty Calculator
Turn your projected score into the dollar adjustment on your Part B revenue.
Open the toolThe 2027 Fee Schedule Proposal
A 1.68% conversion factor cut and a proposed end date for traditional MIPS.
Read the articleMore free tools
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