2026 MIPS Final Rule: What’s changing in Quality, Cost, & MVP reporting
By Oncology Supply
The MIPS Consulting team recently hosted a webinar highlighting key updates to the MIPS 2026 Final Rule – including MVP changes, quality measure updates, and stability in the Cost category. Below is a summary of the operational changes practices should be aware of for the 2026 performance year.
MVP updates: New options and added flexibility
CMS finalized several updates to the MIPS Value Pathways (MVPs) framework for the 2026 performance year:
- Six new MVPs added for 2026. CMS introduced six new MVPs, bringing the total to 27. All existing MVPs were modified to reflect broader measure inventory changes. Practices planning to report an MVP should review the 2026 Finalized MVP Guide to confirm their selected measures remain included.
- Updated process for determining specialty composition. Instead of relying on claims data, groups will now attest to their specialty makeup during MVP registration. Small multispecialty groups (15 or fewer clinicians) may continue to register as a single group rather than forming subgroups.
- Extended timeline for registry and QCDR implementation. Qualified registries and QCDRs have until 2027 to implement support for MVPs. Practices intending to report one of the newly finalized MVPs should confirm support from their registry, EHR, or QCDR for the 2026 performance year.
Quality category: New measures and inventory changes
For 2026, CMS finalized moderate updates to the Quality category, including new measures additions, removals, definition changes, and scoring refinements. These updates are designed to reduce redundancy and administrative burden while maintaining quality improvement – offering practices clearer opportunities to improve their scores.
Cost category: Inventory remains stable
The Cost category will maintain 35 measures in 2026. New cost measures will continue through their two-year feedback-only periods before impacting scoring. CMS also finalized refinements to global measures such as Total Per Capita Cost.
Qualifying APM participants
Clinicians who achieve QP status are excluded from MIPS participation and related payment adjustments. To qualify, practice must receive at least 75% of Medicare Part B payments through an advanced APM entity during the performance period or see at least 50% of Medicare patients through an Advanced APM entity.
Support for practices
These updates underscore CMS’s ongoing focus on patient access, care coordination, safety, and public health reporting. Given the complexity of MIPS reporting, Cencora offers comprehensive support – from evidence packet development to SRA guidance and year-round performance monitoring – to help practices prepare confidently and achieve strong results.
Watch the full webinar below and learn more about partnering with us for MIPS reporting support. For questions or details, email our team at info@intrinsiq.com.
