CMS Publishes 2026 Policy Changes for the Quality Payment Program

HeadlineCMS Publishes 2026 Policy Changes for the Quality Payment Program The Centers for Medicare & Medicaid Services (CMS) has issued its, Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Final Rule, which includes policies for the Quality Payment Program (QPP) for the 2026 performance year (PY) and beyond. This rule will be published on November 5, 2025, in the Federal Register. 2026 Policy Highlights We finalized a limited number of policies for QPP, keeping our focus on stability in the program. Our policies support the continuing transformation of the Merit-based Incentive Payment System (MIPS) through MIPS Value Pathways (MVPs), and center on alignment across programs as well as responsiveness to feedback and concerns raised by interested parties. Below are some of the key QPP policies that CMS finalized: Merit-based Incentive Payment System (MIPS) (General) We finalized policies for the 2026 performance period for the MIPS performance categories, which include: The addition of 5 new quality measures, substantive changes to 30 quality measures, and the removal of 10 quality measures. Changes to the Alternative Payment Models (APM) Performance Pathway (APP) Plus quality measure set to maintain alignment with the MIPS quality measure inventory. The establishment of a 2-year informational-only feedback period for new cost measures, allowing clinicians to receive feedback on their score(s) and find opportunities to improve performance before a new cost measure affects their MIPS final score. The addition of 3 new improvement activities, the modification of 7 improvement activities, and the removal of 8 improvement activities. The establishment of a measure suppression policy for the MIPS Promoting Interoperability performance category and the Medicare Promoting Interoperability Program. The suppression of the Electronic Case Reporting measure for the current CY 2025 performance period/2027 MIPS payment year for the MIPS Promoting Interoperability performance category and the Medicare Promoting Interoperability Program. Maintaining Stability in MIPS We maintained the current performance threshold policies, leaving the performance threshold set at 75 points through the 2028 performance year. MVP Development and Maintenance We finalized 6 new MVPs for the 2026 performance period that are related to diagnostic radiology, interventional radiology, neuropsychology, pathology, podiatry, and vascular surgery. We're modifying all 21 existing MVPs, in alignment with proposals to update the quality measure and improvement activity inventories. MVP Registration Groups will attest to their specialty composition (whether they're a single specialty group or multispecialty group that meets the definition of a small practice) during the MVP registration process. Multispecialty small practices would still be able to report an MVP as a group, and they wouldn't be required to form subgroups beginning in the CY 2026 performance period. (i.e., Subgroup reporting would remain optional for multispecialty small practices.) Advanced APMs We added a determination of Qualifying APM Participant (QP) status at the individual level for all eligible clinicians in Advanced APMs, in addition to determinations at the APM Entity level. As part of the effort to simplify this process, we are also adding a calculation based on Covered Professional Services as the set of services used for QP determinations. Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) We revised the definition of a "beneficiary eligible for Medicare Clinical Quality Measures for Accountable Care Organizations Participating in the Medicare Shared Savings Program (Medicare CQMs)", for performance year 2025 and subsequent performance years, to reduce ACOs' burden in the patient matching necessary to report Medicare CQMs because the list of beneficiaries eligible for Medicare CQMs will have greater overlap with the list of beneficiaries that are assignable to an ACO. For More Information Learn more about the CY 2026 Medicare PFS Final Rule and QPP policy changes by reviewing the following resources: 2026 Quality Payment Program Final Rule Fact Sheet and Policy Comparison Table (PDF) Provides an overview of QPP policies in the CY 2026 Medicare PFS Final Rule, and a comparison table showcasing the changes to current QPP policies. 2026 Finalized MIPS Value Pathways Guide (PDF) - Highlights the finalized MVP policy changes, beginning with the 2026 performance year. Medicare Shared Savings Program Fact Sheet - Documents information about finalized policies specific to Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs).   You're getting this message because you subscribed to get email updates from the Centers for Medicare & Medicaid Services (CMS). Update your subscriptions, modify your password or email address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your email address to log in. If you have questions or problems with the subscription service, please contact subscriberhelp.govdelivery.com. This service is provided to you at no charge by Centers for Medicare & Medicaid Services (CMS). This email was sent to mufhandu.o.itsol@blogger.com using GovDelivery Communications Cloud 7500 Security Boulevard · Baltimore MD 21244