American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

MIPS Scoring and Payment Adjustments

MIPS Final Score

An eligible clinician's (EC’s) performance in each of the four Merit-based Incentive Payment System (MIPS) components makes up the EC’s MIPS final score, determining the EC’s payment adjustment. Payment adjustments can be positive, negative, or neutral. A single MIPS final score will factor in performance in the four categories on a 0 to 100 point scale. Each MIPS component is weighted differently in calculating the MIPS final score:

MIPS Component

Scoring Weight (for 2017 program year)



Promoting Interoperability (formerly ACI)


Improvement Activities (IA)




MIPS Payment Adjustments

Payment adjustments are applied based on an EC’s performance two years prior to the calendar year. Therefore, an EC who is a MIPS participant in 2018 will receive a payment adjustment in 2020 based on 2018 data. For 2017 MIPS participants, a maximum of a 5 percent payment adjustment is possible in calendar year 2020.

Calendar Year

Maximum Possible +/- Payment Adjustment


4 percent (based on 2017 performance)


5 percent (based on 2018 performance)


7 percent (based on 2019 performance)

2022 and onward

9 percent (based on 2020 performance)