Appendix G Improvement Activities Performance Category, 2025 Call f

OMB control number: 0938-134
Expiration Date: 02/28/2027

Improvement Activities Performance Category
CY 2025 Call for Improvement Activities Submission Form
Improvement activities recommended for inclusion or modification should be sent using the Improvement
Activities Submission Template (below) to the email: [email protected]. Stakeholders will
receive an email confirmation for their submission. Improvement activities submitted between February 1 and
July 1, 2025 will be considered for inclusion for the CY 2027 performance period/2029 MIPS payment year.
Improvement activities submitted after July 1, 2025 will be considered for inclusion in future years of the Quality
Payment Program. During a public health emergency (PHE), nominations will be accepted outside of the
February 1 through July 1 submission period as long as the improvement activity is relevant to the PHE. All fields
of this form must be completed in order for your submission to be considered. Stakeholders should submit a
modification submission if the improvement activity they submitted or one that refers to a program or policy
they manage requires an update.
We also refer submitters to the 2025 MIPS Improvement Activities list on the CMS Quality Payment Program
resource library, which lists the complete Inventory of current improvement activities for the CY 2025
performance period/2027 MIPS payment year. Submitters should ensure that proposed new activities do not
duplicate existing ones.
MIPS improvement activities considered for selection must meet all 8 of the required acceptance criteria below:
•
•
•

•
•
•
•
•

Relevance to an existing improvement activities subcategory (or a proposed new subcategory);
Importance of an activity toward achieving improved beneficiary health outcomes;
Feasible to implement, recognizing importance in minimizing burden, including, to the extent possible, for
small practices, practices in rural areas, or practices in areas designated as geographic Health Professional
Shortage Areas (HPSAs) by the Health Resources and Services Administration (HRSA);
Evidence supports that an activity has a high probability of contributing to improved beneficiary health
outcomes;
Can be linked to existing and related MIPS quality, Promoting Interoperability, and cost measures as applicable
and feasible;
CMS is able to validate the activity;
Does not duplicate other improvement activities in the Inventory; and
Should drive improvements that go beyond purely common clinical practices.

MIPS improvement activities considered for selection can also meet one or more of the optional acceptance
criteria below. Meeting one or more of the optional criteria may increase a submission’s chances of being added
to the Inventory:
•

1

Alignment with patient-centered medical homes;

•
•
•
•
•

Support for the patient’s family or personal caregiver;
Responds to a PHE as determined by the Secretary;
Addresses improvements in practice to reduce health care disparities;
Focus on meaningful actions from the person and family’s point of view; and
Representative of activities that multiple individual MIPS eligible clinicians or groups could perform (for
example, primary care, specialty care).

Proposed New Improvement Activities Recommended for Inclusion in the Quality
Payment Program: Submission Template
Activity Sponsor:
Provide entity name, URL, and individual contact
information: name, address, phone, email—in case we
need to contact submitter.
CMS NPI # or Sponsor Type:
Include NPI number, or indicate other entity type, e.g.,
EHR vendor, specialty group, or other—25 words or less.
Activity Title:
Provide the activity title only—10 words or less.
Activity Description:
Provide a brief description of the proposed activity—
300 words or less. Please be as specific as possible about
what the activity entails. E.g., “MIPS eligible clinician
must perform/do XXXX.”
Proposed Subcategory:
Select the ONE (1) subcategory under which your
proposed improvement activity best fits from among
the following eight options:
•
Achieving Health Equity
•
Behavioral and Mental Health
•
Beneficiary Engagement
•
Care Coordination
•
Emergency Response and Preparedness
•
Expanded Practice Access
•
Patient Safety and Practice Assessment
•
Population Management

2

Rationale and Supporting Documentation (e.g., peerreviewed articles, other publications, websites)
Describe how this activity would meet the acceptance
criteria listed above. Provide supporting documentation
that indicates that this activity has been used
successfully in the field, and that it can lead to practice
quality improvement and improvement in patient
health, experience, etc. Please provide citations of or
links to established processes, validated tools, etc., that
are referenced in the activity.
Documentation to Use as Proof of Activity Completion:
Include data or primary sources that a MIPS eligible
clinician could use to validate performance of the
improvement activity (e.g., medical charts, office
schedules, data reports, quality improvement reports or
submissions to funders/payers, meeting minutes).
Level of Effort:
Include data, primary sources or personal experience to
substantiate the level of effort the submitter anticipates
are required to complete the proposed improvement
activity on an annual basis. (This estimate could be in
hours/days, dollars, staffing needs/FTE, external
resources/supports or any combination thereof).

Proposed Modifications to Improvement Activities Recommended for Inclusion in the
Quality Payment Program: Submission Template
Existing IA Proposed to Modify (please list IA
subcategory/number, e.g., IA_AHE_1):
Modification proposed: Please check off the type of
modification you are proposing

Please list the modification you propose
INCLUDING a rationale for why you believe this
modification is warranted.

3

•
•

Subcategory
Description

According to the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.), no persons are required to respond
to a collection of information unless it displays a valid OMB control number. The valid OMB control number for
this information collection is 0938-1314 (Expiration date: 2/28/2027). This information collection is the tool for
improvement activities submission for consideration by CMS. The time required to complete this information
collection is estimated to average 4.4 hours per response, including the time to review instructions, search
existing data resources, gather the data needed, to review and complete the information collection. This
information collection is voluntary and all information collected will be kept private in accordance with
regulations at 45 CFR 155.260, Privacy and Security of Personally Identifiable Information.  Pursuant to this
regulation, CMS may only use or disclose personally identifiable information to the extent that such information
is necessary to carry out their statutory and regulatory mandated functions. If you have comments concerning
the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security
Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, MD 21244-1850. If you have
questions or concerns regarding where to submit your documents, please contact QPP at [email protected].

4