Traditional Merit-Based Incentive Payment System (MIPS)

The Academy is committed to helping ophthalmologists succeed in MIPS and avoid penalties. We believe MIPS requirements should reflect the realities of ophthalmic practice — and that quality measures used for ophthalmology reporting should be developed by ophthalmologists, for ophthalmologists.

The Academy also advocates for MIPS policies that reduce administrative burden on physician practices and ensure ophthalmologists have a viable path to avoid penalties.

IRIS® Registry

The Academy's IRIS® Registry — a CMS-approved Qualified Clinical Data Registry (QCDR) — is the Academy's primary tool for helping ophthalmologists navigate MIPS reporting. As a QCDR, the IRIS Registry can develop its own ophthalmology-specific quality measures that go beyond the standard CMS inventory, giving members more relevant and meaningful reporting options. The IRIS Registry also offers the largest selection of ophthalmic quality measures available through any registry, including exclusive QCDR measures members cannot report elsewhere. The number of available measures is updated each year — visit the quality measures webpage for the current year's full measure inventory.

Complete Ophthalmologic Care MVP

For 2025, CMS introduced the first MIPS Value Pathway (MVP) specific to ophthalmology — the Complete Ophthalmologic Care MVP. The Academy is actively engaged in refining this pathway and advocating for improvements. Currently, reporting through the ophthalmology MVP is voluntary, but CMS has signaled its intent to eventually sunset traditional MIPS and transition to mandatory MVP reporting. The Academy is advocating to keep MVP reporting voluntary and preserve ophthalmologists’ flexibility to choose the reporting pathway and measures that best reflect their practice.

Annual rulemaking advocacy

The Academy reviews and comments on CMS's annual Medicare Physician Fee Schedule proposed rule, which includes MIPS program changes, advocating for policies that reduce burden and support ophthalmologists' ability to earn positive payment adjustments. A recent example: the Academy's advocacy contributed to a correction of the Total Per Capita Cost (TPCC) measure attribution methodology, which had been inappropriately used in some ophthalmology practices’ cost scores, particularly in practices employing nurse practitioners or physician assistants.  

Check your MIPS eligibility status each year — not all ophthalmologists are required to participate, but those who are eligible and fail to report face payment penalties. 

• Use the CMS QPP Participation Status Tool to confirm your status for the current performance year. 
• Bookmark this page for the latest guidance on measures, deadlines, and reporting tips.

Under MIPS — established by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 — CMS evaluates eligible clinicians' performance across four categories each year. Your final score determines whether you receive a positive, neutral, or negative payment adjustment for Medicare Part B–covered professional services, applied two years after the performance year.

The four MIPS performance categories and their standard weights in the final score are:

• Quality — 30%
• Cost — 30%
• Promoting Interoperability — 25%
• Improvement Activities — 15%

(Note: CMS may reweight categories for certain physicians, such as those in small practices.)

The performance threshold is currently set at 75 points out of 100, and is maintained at that level through the 2028 performance year (affecting the 2030 payment year). Scores above 75 earn a positive payment adjustment; scores equal to 75 receive a neutral adjustment; and scores below 75 are subject to a negative adjustment of up to 9%.