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MIPS 2020 Final Rule: Improvement Activities Category


The Improvement Activities category remains at 15 percent of the total MIPS score.

The Improvement Activities (IA) category remains at 15 percent of the total MIPS score.

In activity weights, the medium activity weights are worth 10 points, and the higher activities are worth 20 points. If your practice or eligible clinicians qualify for a special status this year, the medium activity weights are worth 20 points and the high activity points are worth 40. The special status is typically for clinicians in small, rural and underserved practices, or with non-patient facing clinicians or groups. You can find your status on the Quality Payment Program (QPP) eligibility tool.

In addition, you may also receive credit for participation in certain improvement activities or payment models, such as a recognized Patient-Centered Medical Home (PCMH) or participate in an APM whose participants are not scored under the APM Scoring Standard.

CMS also finalized the formal definition of a rural area, using data from Health Resources & Service Administration (HRSA), but ZIP codes did not change. CMS also expanded the definition of the Patient-Centered Medical Home and comparable specialty practice. That information can be found on the QPP Resource page of their website.

One of the most significant changes in this category is that CMS now requires that at least 50 percent of the MIPS eligible clinicians in the group or virtual group need to participate in the activity for the group to receive credit. And they must perform in the same continuous 90-day period, with the same activity. The data from a single participant will no longer qualify as completing for the group.

The QPP Resource Library has the full list of the Improvement Activities available for the 2020 performance year, including the two new activities. Practices should ensure they are selecting activities from the 2020 inventory as 15 measures were removed and seven were modified.

For 2020 MIPS reporting, CMS will calculate your score for the Improvement Activities category based on data of at least a 90 consecutive day period, counting toward 15 percent of your MIPS final score. Data must meet the following:

  • Complete at least 40 points toward IA activities, from either medium- or high-weighted measures,
  • And groups must have at least 50 percent of their MIPS ECs participating in the same activities for the same performance period.

Information for this article was taken from the MIPS 2020 Final Rule webinar presented in January by the Quality Reporting Engagement Group. The team is ready to assist with all your MIPS needs, from submission assistance for 2019 reporting to a full-service consulting partnership for 2020. Contact them at