If you’re participating in the 2025 Medicare Advantage Primary Care Physician Incentive Program (MA-PCPi), you can earn points when you reach specific Performance Targets or Improvement Targets for your patients who are UnitedHealthcare® Medicare Advantage members. Payments are based on your total earned Performance Points at the end of the year.
As part of this new incentive, your practice can earn an annual bonus when you achieve at least 45+ points.
| MA-PCPi Performance Points | Payment per member per year |
|---|---|
| 100+ | $300 |
| 95–99 | $250 |
| 90–94 | $200 |
| 85–89 | $150 |
| 80–84 | $125 |
| 75–79 | $100 |
| 70–74 | $80 |
| 65–69 | $65 |
| 60–64 | $50 |
| 55–59 | $40 |
| 50–54 | $30 |
| 45–49 | $20 |
| 0–44 | $0 |
| Performance | OR | Improvement | ||||||
|---|---|---|---|---|---|---|---|---|
| Tier 1 | Tier 2 | |||||||
| 2025 Star Rating ID | Quality Care Measure | Target | Eligible points | Target | Eligible points | Target | Eligible points | |
| C01 | Breast Cancer Screening (BCS-E) | 77% | 2 | 84% | 3 | 10% | 5 | |
| C02 | Colorectal Cancer Screening (COL-E) | 72% | 2 | 81% | 3 | 10% | 5 | |
| C09 | Eye Exam for Patients With Diabetes (EED) | 81% | 2 | 88% | 3 | 10% | 5 | |
| C10 | Glycemic Status Assessment for Patients With Diabetes (GSD) | 88% | 2 | 94% | 3 | 10% | 5 | |
| C11 | Controlling High Blood Pressure (CBP) | 83% | 5 | 88% | 5 | 15% | 10 | |
| C15 | Plan All-Cause Readmissions (PCR) | 10% | 2 | 8% | 3 | 3% | 5 | |
| C16 | Statin Therapy for Patients With Cardiovascular Disease (SPC) | 88% | 5 | 92% | 5 | 5% | 10 | |
| D08 | Medication Adherence for Diabetes Medications (MAD) | 88% | 5 | 91% | 5 | 5% | 10 | |
| D09 | Medication Adherence for Hypertension (RAS Antagonists) (MAH) | 91% | 5 | 93% | 5 | 5% | 10 | |
| D10 | Medication Adherence for Cholesterol (MAC) | 90% | 5 | 93% | 5 | 5% | 10 | |
| D12 | Statin Use in Persons With Diabetes (SUPD) | 90% | 5 | 93% | 5 | 5% | 10 | |
| DMC22 | Kidney Health Evaluation for Patients With Diabetes (KED) | 61% | 2 | 74% | 3 | 10% | 5 | |
| N/A | Getting needed care | 93% | 2 | 96% | 3 | 4% | 5 | |
| N/A | Care coordination | 91% | 2 | 94% | 3 | 4% | 5 | |
Your practice can earn Extra Credit Points for meeting or exceeding the metric(s) defined below. Extra Credit Points are added in addition to the points total.
| Extra Credit Metric | Period | Points value |
|---|---|---|
| ACV rate completion of 70%+ | Current calendar year | 2 |
This example is based on a practice’s 2025 MA-PCPi year-end performance. Their total Performance Point Bonus is 58, which would qualify them to earn the $40 PMPY bonus.
| 2025 Star Rating ID | Quality Care Measure | Measure Performance Percentage | Prior year measure Performance Percentage | Tier achieved | Points achieved |
|---|---|---|---|---|---|
| C01 | Breast Cancer Screening (BCS-E) |
79% | 65% | Tier 1 & Improvement Target | 5 |
| C02 | Colorectal Cancer Screening (COL-E) |
76% | 72% | Tier 1 | 2 |
| C09 | Eye Exam for Patients With Diabetes (EED) | 90% | 83% | Tier 1 & Tier 2 | 5 |
| C10 | Glycemic Status Assessment for Patients With Diabetes (GSD) | 90% | 86% | Tier 1 | 2 |
| C11 | Controlling High Blood Pressure (CBP) | 65% | 61% | N/A | 0 |
| C15 | Plan All-Cause Readmissions (PCR) | 8% | 9% | Tier 1 & Tier 2 | 5 |
| DMC22 | Kidney Health Evaluation for Patients With Diabetes (KED) | 75% | 55% | Tier 1, Tier 2 & Improvement Target |
5 |
| C16 | Statin Therapy for Patients With Cardiovascular Disease (SPC) | 87% | 89% | N/A | 0 |
| D08 | Medication Adherence for Diabetes Medications (MAD) | 92% | 91% | Tier 1 & Tier 2 | 10 |
| D09 | Medication Adherence for Hypertension (RAS Antagonists) (MAH) | 88% | 86% | N/A | 0 |
| D10 | Medication Adherence for Cholesterol (MAC) | 90% | 90% | Tier 1 | 5 |
| D12 | Statin Use in Persons With Diabetes (SUPD) | 85% | 78% | Improvement Target | 10 |
| N/A | Getting needed care | 94% | 92% | Tier 1 | 2 |
| N/A | Care coordination | 90% | 85% | Improvement Target | 5 |
| Total points | 56 | ||||
| Extra credit metric | Performance Percentage | Outcome | Points achieved | ||
| Annual care visit rate 70+ | 75% | Metric met | 2 | ||
| Total points + extra credit | 58 | ||||
If there is a conflict between this page and the Terms and Conditions, the Terms and Conditions control.