Avoiding 2025 MIPS Penalties: What Small Practices Must Do Now

A simple guide to protect your revenue and report with confidence in 2025.

Introduction

Small and solo practices have always faced a tough road in MIPS. Limited resources, unclear rules, and changing reporting requirements make it easy to fall behind and in 2025, the financial consequences are more real than ever.

This year, a low MIPS score could lead to a penalty of up to 9% on your Medicare Part B reimbursements. That’s not just a performance issue that’s lost revenue your practice likely can’t afford.

Here’s what small practices must do now to stay out of the penalty zone and protect every dollar they’ve earned.

1. Know Your Eligibility (Don’t Assume You’re Exempt)

Even if you're a solo provider or part of a small group, you may still be required to report and penalties apply if you don’t.

Here’s how to check:

• Visit the QPP Participation Status Tool
• Enter your NPI to confirm whether you're required to report under MIPS in 2025
• Check if you’re reporting as an individual or a group (the difference matters)

Tip: Many providers get penalized simply because they didn’t realize they were required to report.

2. Submit Data for All Required Categories

To avoid penalties, you must report in all performance categories where you're eligible:

• Quality (30%)
• Promoting Interoperability (25%)
• Improvement Activities (15%)
• Cost (30%) calculated automatically, but still affects your score

Missing even one category (or submitting incomplete data) can pull your total score below the 75-point penalty threshold.

3. Choose Measures That Actually Work for You

Your EHR may limit what measures you can report and many small practices don’t realize this can tank their score.

What to do:

• Use a registry to access a broader range of quality measures
• Focus on high-performing benchmarks in your specialty
• Avoid low-scoring or high-variation measures where small numbers hurt your average

Flow8Health helps you select the right measures based on your specialty, size, and previous performance.

4. Monitor Performance Early Don’t Wait for Year-End

By the time submission is due, it’s often too late to fix underperforming measures.

What to do:

• Track your performance quarterly or monthly
• Identify and fix data gaps early
• Document all improvement activities well in advance

Real-time tracking is the difference between penalty risk and bonus eligibility.

5. Don’t Assume Your EHR is “Handling It”

EHRs submit but they don’t strategize. Many practices using EHR-only reporting:

• Submit incomplete or non-optimized data
• Miss entire categories (like IAs)
• Have no insight into projected scores

That’s how practices making all the right moves still end up with penalties.

The solution? Registry-based reporting with expert oversight.

Conclusion: Don’t Let a Score Hurt Your Bottom Line

A single penalty could cost your practice thousands of dollars in lost reimbursements and the damage compounds year after year.

Avoiding penalties in 2025 isn’t just about checking boxes. It’s about strategy, tracking, and expert guidance.

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