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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.
MIPS composite scores and payment adjustments render on individual provider profiles (NPI-matched) with full provenance (source · performance year · methodology version). Powers the brand-hub clinician-quality module and the dbt QPP mart. 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.
Per-field display contract.
Every field below has a `display_allowed` flag in the §94 provenance schema. Write-locked fields are captured to provenance for audit but never rendered on profile pages.
Renders on profile
9 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, refresh cadence.
Authority
U.S. Centers for Medicare and Medicaid Services
Tier
Tier-2 · profile-enrichment (renders on matched profiles)
Refresh cadence
Annual (July, post-performance-year scoring)
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.
A worked example. Every field surfaced from this source carries this shape of provenance line — source · last checked · display rule · confidence (when applicable).
Field
MIPS final composite score (profile)
Sample value
Final score: 82.5/100 · Exceptional · PY2023 · NPI 1063717142
Provenance line
Source: CMS QPP MIPS · Performance Year 2023 · Methodology cms-qpp-mips/v1 · Display rule: per-clinician final_score + payment_adjustment_pct render on provider profile with performance year inline
Where this source already shows up.
Verticals where this source renders today
- dermatologists
- plastic-surgeons
- chiropractors
- /sources → The full source library — every dataset Fonteum cites.
- /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
- /methodology → Network-wide sourcing, refresh cadence, and corrections policy.
- /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.
Compliance posture
We don’t sell ranking and don’t accept payment to move a provider up the list. For final hire decisions, verify licensing, insurance, and references directly with the applicable licensing or credentialing body.
No bulk-licensing source family is currently ingested for this vertical. Hire-time checking still routes through the body named above.