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Centers for Medicare & Medicaid Services Quality Payment Program
Reminder to Submit Comments on the CY 2026 CMS Proposes Policy Changes for Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) has issued its Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule [ https://www.federalregister.gov/public-inspection/2025-13271/medicare-and-medicaid-programs-calendar-year-2026-payment-policies-under-the-physician-fee-schedule ], which includes proposed policies for the Quality Payment Program (QPP).

The Notice of Proposed Rulemaking (NPRM) includes proposals for the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), as well as several Requests for Information (RFIs).

Specifically, we’re proposing policies that:


* Continue the transformation of MIPS through MIPS Value Pathways (MVPs).
* Are responsive to feedback and concerns raised by interested parties.
* Maintain stability within the MIPS program through the established performance threshold.

2026 Policy Proposal Highlights

Key QPP policies that we are proposing in the CY 2026 PFS Proposed Rule include:


* Introducing 6 new MVPs for the 2026 performance year that are related to diagnostic radiology, interventional radiology, neuropsychology, pathology, podiatry, and vascular surgery.
* Introducing 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.
* Maintaining the current performance threshold policies, leaving the performance threshold set at 75 points through the 2028 performance year.
* Introducing Qualifying APM Participant (QP) determinations at the individual level, in addition to existing determinations at the APM entity level.

Overview of RFIs

We are also seeking feedback on RFIs about the following topics:


* Establishing Core Elements for MVPs, to require reporting on key quality measures within each MVP.
* Establishing a process to assign clinicians to an MVP, to facilitate the most relevant reporting for their scope of care.
* Transitioning to FHIR-based electronic clinical quality measure (eCQM) reporting in quality reporting programs.
* Understanding the current environment, including challenges, with collecting and exchanging high-quality healthcare data.
* Changing requirements for the Query of Prescription Drug Monitoring Program (PDMP) Measure and Performance-Based Measures in the Public Health and Clinical Data Exchange Objective.

How Do I Comment on the CY 2026 Proposed Rule?

The proposed rule includes directions for submitting comments within the 60-day comment period. *We must receive comments by 9/12/2025*.

When commenting, refer to file code: CMS-1832-P.

*We don’t accept FAX transmissions.*

Use 1 of the 3 following ways to officially submit your comments:


* *Electronically:* regulations.gov [ http://www.regulations.gov ]
* *Regular mail:* Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1807-P, P.O. Box 8016, Baltimore, MD 21244-8016.
* *Express or overnight mail:* Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1832-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

Additional Resources

Learn more about the QPP proposals by reviewing the following 2026 QPP Proposed Rule Resource:


* *2026 Quality Payment Program Proposed Rule Fact Sheet and Policy Comparison Table (PDF)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3362/2026-QPP-Proposed-Rule-Fact-Sheet-and-Policy-Comparison-Table.pdf ] – Provides an overview of QPP proposals and RFIs included in the CY 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule, and a comparison table contrasting existing policies with proposals.

Visit the Quality Payment Program (QPP) Resource Library to Access Updated 2025 Qualified Clinical Data Registry (QCDR) and Qualified Registry Qualified Postings

The 2025 QCDR and Qualified Registry Qualified Postings have been updated to reflect new or resolved remedial actions and/or terminations applied to the third party intermediaries included within these resources. Visit the QPP Resource Library [ https://qpp.cms.gov/resources/resource-library ] to access the updated 2025 QCDR and Qualified Registry Qualified Postings and review the Version History tab within the qualified postings for more detailed information regarding these updates.

DAC CY 2023 Preview Period Ending Tomorrow

The Doctors and Clinicians (DAC) calendar year (CY) 2023 Preview Period that reopened in July is *ending tomorrow, August 21, 2025, at 8 p.m. ET (5 p.m. PT)*.

If you haven’t previewed your CY 2023 Quality Payment Program (QPP) performance information already, don’t miss your chance to review before it’s publicly reported on the profile pages of clinicians and groups on the Medicare.gov compare tool [ https://www.medicare.gov/care-compare/ ] and in the Provider Data Catalog (PDC) [ https://data.cms.gov/provider-data/ ]. You can access the secure preview on the QPP website [ https://qpp.cms.gov/login ] and review your information until the Preview Period ends.

CMS reopened the Preview Period because adjustments were made resulting in the addition of 2 clinician quality measures and 17 group quality measures available for public reporting. CMS also made updates and display corrections to the CY 2023 QPP performance data available during the Preview Period that ended in June.

Even if you already reviewed your CY 2023 QPP performance information during the previous Preview Period, CMS encourages you to review your performance information again for any changes before this information is released to the public.

CMS revised the CY 2023 QPP performance information documents available for preview. These documents are available in the Downloads section on the Care Compare: Doctors and Clinicians Initiative webpage [ https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps%3A%252F%252Fwww.cms.gov%252FMedicare%252FQuality-Initiatives-Patient-Assessment-Instruments%252FCompare-DAC%2F1%2F0101019838a65208-97365054-1121-4889-a1e3-b83df2a665bd-000000%2FM-mbSHfd1OenQ52F2mNrKworLN3fMM1t4WQIGXAB1vs%3D415&data=05%7C02%7CRachel.Small%40rainmakerssolutions.com%7C04710f54459f4b4f639c08ddca1ad982%7C2e84e31661f24a28b251479f15f7c3d5%7C0%7C0%7C638888939031655197%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=OXz7B2jBb1DQXDQYkjOGc8%2Bo%2F8hOIPp6A8%2BKKGAYOp8%3D&reserved=0 ] and in the 2023 Doctors and Clinicians Preview Period file (2MB) (ZIP) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3380/2023%20Doctors%20and%20Clinicians%20Preview%20Period.zip ] in the QPP Resource Library [ https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps%3A%252F%252Fqpp.cms.gov%252Fresources%252Fresource-library%2F1%2F0101019838a65208-97365054-1121-4889-a1e3-b83df2a665bd-000000%2FFhMML0ZNN3dlGro-Wp8hCiil2OhHT3XvTvZ2IunzkjI%3D415&data=05%7C02%7CRachel.Small%40rainmakerssolutions.com%7C04710f54459f4b4f639c08ddca1ad982%7C2e84e31661f24a28b251479f15f7c3d5%7C0%7C0%7C638888939031701589%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=CU91PGWQ96XKfK7te1zUSop6IRNv4LQTGpVgRTkg6E4%3D&reserved=0 ]:


* Clinician Performance Information on the Compare Tool on Medicare.gov: CY 2023 Clinicians Public Reporting (692KB) (PDF) [ https://edit.cms.gov/sites/default/files/2025-07/cy23dacperformanceinfov2.0_0.pdf ]__
* CY 2023 Medicare.gov Compare Tool Clinician Star Rating Cut-offs for Clinicians and Groups (119KB) (XLSX) [ https://edit.cms.gov/sites/default/files/2025-07/2023dacpreviewstarratings-v2.0_0.xlsx ]__
* CY 2023 Doctors and Clinicians Performance Information: Guide to the Preview Period (892KB) (PDF) [ https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps%3A%252F%252Fedit.cms.gov%252Fsites%252Fdefault%252Ffiles%252F2025-07%252Fcy23dacpreviewperiodguidev1.0_0.pdf%2F1%2F0101019838a65208-97365054-1121-4889-a1e3-b83df2a665bd-000000%2FqKWz8qdknEsjwANC5sNDsn0DE9afY2V7bPKASAaCCUE%3D415&data=05%7C02%7CRachel.Small%40rainmakerssolutions.com%7C04710f54459f4b4f639c08ddca1ad982%7C2e84e31661f24a28b251479f15f7c3d5%7C0%7C0%7C638888939031792036%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=qG9xKBVDYgUL7J6i5a1eYPaHg3xd7j3BpT1iqOPSfnA%3D&reserved=0 ]__
* Addendum for Clinicians Who Opted Out of Public Reporting in May or June 2025: Guide to the 2023 Doctors and Clinicians Preview Period Performance Information (492KB) (PDF) [ https://edit.cms.gov/sites/default/files/2025-07/cy23dacpreviewguideaddendumv1.0_0.pdf ]__
* Measure Release Notes to Clinician Performance Information on the Medicare.gov Compare Tool for CY 2023 Clinicians Public Reporting (144KB) (PDF) [ https://edit.cms.gov/sites/default/files/2025-08/cy23dacmeasurereleasenotesv1.0.pdf ]__

For step-by-step instructions on how to review your information in the secure preview, check out the Doctors and Clinicians Preview Period: Performance Information video [ https://www.youtube.com/watch?v=3jDkgskhtnY ].

Note that Accountable Care Organization (ACO) group-level data won’t be available on the QPP website during the Preview Period. Merit-based Incentive Payment System (MIPS) eligible clinicians who participate in Medicare Shared Savings Program ACOs will be able to preview their performance information in their 2023 MIPS Performance Feedback.

For more help accessing the QPP website [ https://nam10.safelinks.protection.outlook.com/?url=https%3A%2F%2Flinks-2.govdelivery.com%2FCL0%2Fhttps%3A%252F%252Fnam10.safelinks.protection.outlook.com%252F%253Furl%3Dhttps%25253A%25252F%25252Flinks-2.govdelivery.com%25252FCL0%25252Fhttps%25253A%2525252F%2525252Fqpp.cms.gov%2525252Flogin%2525253Fpage%25253Dregister%25252F1%25252F01010196f3e8d5e8-b41478e6-d560-43d5-9565-7979f420cb30-000000%25252F4gcI9Ao-f3jXEdCnnoYWbdJ4aX58ryAMsjNj61XQ_NE%25253D406%2526data%3D05%25257C02%25257Crachel.small%252540rainmakerssolutions.com%25257Cfd000e3686a647546d3208dd9d30c5e8%25257C2e84e31661f24a28b251479f15f7c3d5%25257C0%25257C0%25257C638839555353425292%25257CUnknown%25257CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%25253D%25253D%25257C0%25257C%25257C%25257C%2526sdata%3DAtLPex4nffsVdighm0ssLUBCH%25252BkEImJ%25252B5kE6fV8Hteo%25253D%2526reserved%3D0%2F1%2F010101988a3df086-faf893d8-8a68-490a-994a-6f6367b13c8d-000000%2F_GWZSZxpjVjRAPxgV-sZU4K6JssmF4SAA2iQhSL76BA%3D417&data=05%7C02%7CRachel.Small%40rainmakerssolutions.com%7C08e0e7c7d29340678fc208ddd68e0b90%7C2e84e31661f24a28b251479f15f7c3d5%7C0%7C0%7C638902628098993647%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=jl4yjHF2tYhmX88AZdOxMEBBfcCkw8yU3SxW6Ag5FjU%3D&reserved=0 ] or getting your Health Care Quality Improvement Systems (HCQIS) Access Roles and Profile (HARP) user role, email the QPP Service Center at QPP@cms.hhs.gov. To learn how to sign up for a HARP account [ https://qpp.cms.gov/login?page=register ], review the QPP Access User Guide (4MB) (ZIP) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2955/QPP-Access-User-Guide.zip ].

Reminder: Register Now for the 2026 Self-Nomination and QCDR Measure Submission Question and Answer Session on August 21

As a reminder, the Centers for Medicare & Medicaid Services (CMS) will host a virtual question and answer (Q&A) session on *Thursday, August 21, 2025,* from *1 – 2:30 p.m. ET. *Participants can ask questions during this Q&A session about the Qualified Clinical Data Registry (QCDR) and Qualified Registry Self-Nomination and QCDR Measure Submission processes for the 2026 Merit-based Incentive Payment System (MIPS) performance period.

Participants are encouraged to ask questions regarding the QCDR and Qualified Registry Self-Nomination forms available on the Quality Payment Program (QPP) website [ https://qpp.cms.gov/ ] as well as the QCDR Measure Submission process for those submitting QCDR measures.

*What are QCDRs and Qualified Registries?*

QCDRs and Qualified Registries are CMS-approved third party intermediaries that collect clinical data on behalf of clinicians for data submission. Only intermediaries that want to become (and that meet the requirements of) a QCDR and/or Qualified Registry need to complete the Self-Nomination form.

You should attend the session if your organization plans to self-nominate as a 2026 QCDR or Qualified Registry. Participation in this session is *optional*. MIPS eligible clinicians, groups, virtual groups, subgroups, and Alternative Payment Model (APM) Entities, including Medicare Shared Savings Program, that want to report for the 2026 MIPS performance year via a QCDR or Qualified Registry reporting mechanism don’t need to self-nominate.

*Session Details*

*Title:* 2026 Self-Nomination and QCDR Measure Submission Question and Answer Session *Date:* Thursday, August 21, 2025 *Time:* 1 – 2:30 p.m. ET

To register for the 2026 Self-Nomination and QCDR Measure Submission Question and Answer Session, please email the QCDR Vendor Support Inbox at QCDRVendorSupport@gdit.com or Qualified Registry Vender Support Inbox at RegistryVendorSupport@gdit.com, and you’ll be provided the registration link to participate. 

If you don’t receive a confirmation email or if you have any registration questions, please contact us at QCDRVendorSupport@gdit.com or RegistryVendorSupport@gdit.com.

Reminder: The 2026 Qualified Clinical Data Registry (QCDR) and Qualified Registry Self-Nomination Period Closes on September 2

The Centers for Medicare & Medicaid Services (CMS) would like to remind you that the deadline of the 2026 Self-Nomination period for Qualified Clinical Data Registries (QCDRs) and Qualified Registries is *September 2, 2025, at 8 p.m. ET*. The Self-Nomination form on the Quality Payment Program (QPP) website [ https://qpp.cms.gov/ ] will lock at the deadline, and users won’t be able to make additional edits.

Please ensure that your 2026 QCDR or Qualified Registry Self-Nomination form is complete, and then click the *Submit for Review* button on the QPP website before the deadline.

You can only submit the Self-Nomination form for review after all required fields are complete on each tab. Each tab has a vertical progress indicator on the left side of the form. A green checkmark shows you’ve completed the tab, and the *Submit for Review* button becomes enabled when all the required fields are completed. Once you’ve selected the *Submit for Review* button, the Intermediary landing page will list your Self-Nomination form with the nomination status, “In Self-Nomination Review.”

Once submitted, check your application periodically for any follow-up questions regarding your Self-Nomination form, QCDR measures, and/or correspondence, as there’s a high volume of notifications from the MIPS QCDR/Registry Support Team (Practice Improvement and Quality Measure Management Support (PIQMMS) Team) regarding follow-up.

If you should have a simplified Self-Nomination form, but are unable to access it, please contact the PIQMMS Team at QCDRVendorSupport@gdit.com or RegistryVendorSupport@gdit.com. *Don’t* *create and submit a new Self-Nomination **form for your organization.*

Sharing Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) account credentials with other users isn’t permitted and is considered a security violation. Ensure that a member of your organization has a HARP [ https://harp.cms.gov/register/profile-info ] account to sign in to the QPP website with the appropriate associated role at all times and that appropriate coverage is in place if the lead Self-Nomination contact person is out of the office. Each individual user must have their own HARP account to log in to the QPP website [ https://qpp.cms.gov/ ]. Unauthorized or improper use of this system is prohibited and may result in disciplinary action and/or civil and criminal penalties.

*For More Information*

Visit the QPP Resource Library [ https://qpp.cms.gov/about/resource-library ] to download the 2026 Self-Nomination Toolkit for QCDRs and Qualified Registries [ https://qpp-cm-prod-content.s3.us-east-1.amazonaws.com/uploads/3324/2026%20Self-Nomination%20Toolkit%20for%20QCDRs%20and%20Registries.zip ] (ZIP, 5MB) and learn more about the QCDR and Qualified Registry Self-Nomination process.

CMS Is Excluding the Acute Kidney Injury Requiring New Inpatient Dialysis Cost Measure for Calendar Year (CY) 2024 Performance Period/2026 Payment Year of the Merit-Based Incentive Payment System (MIPS)

After conducting empirical analyses of the cost measures specified for the CY 2024 performance period/2026 MIPS payment year, CMS identified that the Acute Kidney Injury Requiring New Inpatient Dialysis (AKI) measure warrants exclusion from our calculation of MIPS eligible clinicians’ scores under the cost performance category in accordance with our measure exclusion policy at 42 C.F.R. § 414.1380(b)(2)(v)(B) [ https://www.ecfr.gov/current/title-42/part-414/subpart-O#p-414.1380(b)(2)(v)(B) ].


* *Therefore, the AKI measure won’t be included in the calculation of MIPS eligible clinicians’ scores under the cost performance category for the CY 2024 performance period/2026 MIPS payment year.*

Our empirical analysis of the AKI episode-based cost measure for the CY 2024 performance period/2026 MIPS payment year showed that the measure’s risk adjustment model didn’t consistently estimate costs for the CY 2024 performance period/2026 MIPS payment year. Specifically, the AKI measure didn’t adequately estimate costs for episodes where beneficiaries were identified as low-risk. This finding demonstrates that the risk-adjustment model underestimated costs for the lowest risk patients (as compared to actual costs), *which may lead to misleading and* inaccurate measure scores for MIPS eligible clinicians with a larger share of these episodes.

For more information about the exclusion of the AKI measure, please see the 2024 Performance Period / 2026 MIPS Payment Year MIPS Cost Measure Exclusion Fact Sheet [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3389/2024-MIPS-Cost-Measure-Exclusion-Fact-Sheet.pdf ].

*Additional Resources – CY 2024 MIPS performance period/2026 MIPS payment year*

Additional information about the cost measures that will be calculated and reported under the cost performance category, as well as the AKI measure, is available here:__


* 2024 Cost Measure Information Forms [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2654/2024-cost-measure-information-forms.zip ]
* 2024 Cost Measure Codes Lists [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2653/2024-cost-measure-codes-lists.zip ]
QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


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