MIPS Improvement Activities Performance Category

MIPS Improvement Activities Performance Category (2026)

The MIPS Improvement Activities performance category rewards eligible clinicians (ECs) and groups for engaging in clinical practice improvement activities such as care coordination, beneficiary engagement, and patient safety. Improvement Activities account for 15% of the total MIPS score in performance year 2026. Most anesthesiologists and their groups will attest to the MIPS Improvement Activities category via a Qualified Registry, a Qualified Clinical Data Registry, or though the Quality Payment Program website.

CMS has finalized a list of more than 100 activities for the 2026 performance year. AQI NACOR supports attestation for more than forty anesthesia-related improvement activities. The list of MIPS Improvement Activities and their data validation requirements are available via the Quality Payment Program Resource Library.

Please make sure to check improvement activities requirements and descriptions each year as CMS adds, deletes, and amends improvement activities.

CMS has streamlined the Improvement Activities inventory in recent performance years to reduce reporting burden.
Attestation requirements:

• For MVP Reporting:
• All clinicians, groups, and subgroups (regardless of special status) need to attest to 1 activity.
• For Traditional MIPS Reporting:
• Special Status Groups (small practice, rural, non-patient facing, or in health professional shortage areas):
• Must attest to 1 activity.
• All Other Clinicians, Groups, and Virtual Groups:
• Must attest to 2 activities.

This change simplifies the process, making it easier for clinicians and groups to meet reporting requirements while maintaining flexibility in participation.

For groups, CMS requires 50% of the group’s National Provider Identifier (NPI) clinicians to perform the same improvement activity during any continuous 90-day period within the same performance year.

Eligible clinicians and groups are subject to auditing from their data/registry vendor or CMS for up to six years AFTER the performance year. Eligible clinicians and their groups should retain documentation of their improvement activity performance.

MIPS Improvement Activities Performance Category (2025)

The MIPS Improvement Activities performance category rewards eligible clinicians (ECs) and groups for engaging in clinical practice improvement activities such as care coordination, beneficiary engagement, and patient safety. Improvement Activities account for 15% of the total MIPS score in performance year 2025. Most anesthesiologists and their groups will attest to the MIPS Improvement Activities category via a Qualified Registry, a Qualified Clinical Data Registry, or through the Quality Payment Program website.

CMS has finalized a list of more than 100 activities for the 2025 performance year. AQI NACOR supports attestation for more than forty anesthesia-related improvement activities. The list of MIPS Improvement Activities and their data validation requirements are available via the Quality Payment Program Resource Library.

Please make sure to check improvement activities requirements and descriptions each year as CMS adds, deletes, and amends improvement activities.

Starting in 2025, CMS has removed the weighting from Improvement Activities to streamline scoring and align with their ongoing efforts to refine and enhance the activity inventory.

New reporting requirements:

• For MVP Reporting:

• All clinicians, groups, and subgroups (regardless of special status) need to attest to 1 activity.

• For Traditional MIPS Reporting:

• Special Status Groups (small practice, rural, non-patient facing, or in health professional shortage areas):
• Must attest to 1 activity.
• All Other Clinicians, Groups, and Virtual Groups:
• Must attest to 2 activities.

This change simplifies the process, making it easier for clinicians and groups to meet reporting requirements while maintaining flexibility in participation.

For groups, CMS requires 50% of the group’s National Provider Identifier (NPI) clinicians to perform the same improvement activity during any continuous 90-day period within the same performance year.

Eligible clinicians and groups are subject to auditing from their data/registry vendor or CMS for up to six years AFTER the performance year. Eligible clinicians and their groups should retain documentation of their improvement activity performance.