MIPS 2026 Final Rule 

The 2026 MIPS Final Rule is here with updates to Improvement Activities, Quality Measures, Promoting Interoperability, and Cost. Key takeaways include:

Performance Threshold

• Remains 75 points for a neutral adjustment (through 2028)

Improvement Activities

• New activities focus on AI use, oral health, and cognitive screening

Quality Measures

• Benchmarking and scoring methods updated for alignment with Cost
• Several oncology-related measures now topped out

Promoting Interoperability

• Small practices (≤15 clinicians) remain exempt
• 4 new updates for 2026 reporting requirements

Cost

• Revised TPCC rules and attribution updates
• 2-year feedback period added for new cost measures

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