Medicare Part C Improper Payment Measurement (IPM)
The Centers for Medicare & Medicaid Services (CMS) uses a systematic plan to identify, measure, and report improper Medicare Part C payments each year. Since Fiscal Year (FY) 2008, CMS has submitted an annual Part C improper payment estimate and the estimation methodology to Congress in the Agency Financial Report (AFR). This page highlights important details about the payment error rate and provides useful links and resources for further exploration, with accessible navigation options for all users.
Part C Payment Error Rates from FY 2016 – FY 2025
For FY 2025, CMS reported an Improper Payment Measure (IPM) for the Part C program based on Payment Year 2023 (PY 2023). Table 1 presents the results from the Part C IPM Error Estimates for FY 2016 – FY 2025.
Table 1: Part C Payment Error Estimates for FY 2016 – FY 2025
| Reporting Year1 | Payment Year | Gross Part C Error Rate2 | Gross Dollars in Error ($B) | Net Part C Error Rate3 | Net Dollars in Error ($B) |
|---|---|---|---|---|---|
| FY 2025 | 2023 | 6.09% | $23.67 | 4.94% | $19.20 |
| FY 20244 | 2022 | 5.61% | $19.07 | 4.51% | $15.34 |
| FY 2023 | 2021 | 6.01% | $16.55 | 4.62% | $12.75 |
| FY 20225 | 2020 | 5.42% | $13.94 | 4.44% | $11.43 |
| FY 2021 | 2019 | 10.28% | $23.19 | 3.18% | $7.18 |
| FY 2020 | 2018 | 6.78% | $16.27 | 0.55% | $1.33 |
| FY 2019 | 2017 | 7.87% | $16.73 | 1.33% | $2.83 |
| FY 2018 | 2016 | 8.10% | $15.55 | 1.37% | $2.64 |
| FY 2017 | 2015 | 8.31% | $14.35 | 2.47% | $4.27 |
| FY 2016 | 2014 | 9.99% | $16.18 | 4.19% | $6.79 |
| 1Reporting reflects payment data from two years prior (e.g., FY 2025 reports are based on PY 2023 payments). 2Gross payment error = sum of the absolute value of underpayments and overpayments. 3Net Payment Error = difference between total overpayments and the absolute value of the total underpayments. 4Beginning in FY 2024, ESRD enrollees are included in the error rate calculations, and Hospice enrollees are no longer excluded from the sampled population. 5Methodology changes implemented in PY 2020 (FY 2022 reporting) limit comparability with prior years. | |||||
The authority for CMS activities in Medicare Part C is outlined in the Payment Integrity Information Act of 2019 (PIIA) Public Law (116-117), signed March 2, 2020. PIIA revoked the Improper Payments Information Act (IPIA) of 2002 and its subsequent amendments. It also revoked the Fraud Reduction and Data Analytics Act (FRDAA) of 2015. PIIA incorporates relevant provisions from these acts into a single subchapter in the United States Code.