MIPS Value Pathways (MVPs)

MIPS Value Pathways (MVPs) (2026)

Merit-based Incentive Payment System Value Pathways (MVPs) are a subset of measures and activities, established through rulemaking, that can be used to meet MIPS reporting requirements. 

Those choosing to report MVPs will be able to report their data through AQI NACOR's Qualified Registry (MIPS measures only) or Qualified Clinical Data Registry (QCDR) options (MIPS and QCDR measures may be reported).

The MVP framework aims to align and connect measures and activities across the quality, cost, and improvement activities performance categories of MIPS for different specialties or conditions. In addition, the MVP framework incorporates a foundation that leverages Promoting Interoperability measures and a set of administrative claims-based quality measures that focus on population health in order to reduce reporting burden.

Performance Year 2026

CMS approved a revised "Patient Safety and Support of Positive Experiences with Anesthesia MVP" and introduced a new layout with clinical groupings of measures. MVP scoring and special status designations do not differ from Traditional MIPS policies. Those groups choosing to report the MVP in 2026 will only need to report four quality measures, one improvement activity and promoting interoperability measures (optional depending on your special status designation). CMS will calculate the Medicare Spending Per Beneficiary (MSPB) Clinician measure for the Cost Performance Category.

Eligible clinicians and their groups will need to choose four measures from this designated list:

• Q404: Anesthesiology Smoking Abstinence
• Q430: Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy
• Q463: Prevention of Post-Operative Vomiting (POV) - Combination Therapy (Pediatrics)
• Q477: Multimodal Pain Management
• AQI48: Patient-Reported Experience with Anesthesia
• ABG44: Low Flow Inhalational General Anesthesia
• ePreop31: Intraoperative Hypotension (IOH) Among Non-Emergent Noncardiac Surgical Cases

Eligible clinicians and their groups also have a set of nine (9) improvement activities to choose:

• IA_BE_6: Regularly Assess Patient Experience of Care and Follow Up on Findings
• IA_BE_22: Improved practices that engage patients pre-visit
• IA_BMH_2: Tobacco use
• IA_CC_15: PSH Care Coordination
• IA_CC_19: Tracking of clinician’s relationship to and responsibility for a patient by reporting MACRA patient relationship codes
• IA_MVP: Practice-Wide Quality Improvement in MIPS Value Pathways
• IA_PSPA_1: Participation in an AHRQ-listed patient safety organization
• IA_PSPA_7: Use of QCDR data for ongoing practice assessment and improvements
• IA_PSPA_16: Use of decision support and standardized treatment protocols

Individuals and groups will need to register with CMS during the 2026 performance period to report an MVP. The registration period runs April 1 and November 30th of the performance year. 

Even if you register to report an MVP, you can still choose to report traditional MIPS or the APM Performance Pathway (APP), if applicable.

Subgroup Reporting

CMS defines a subgroup as, “A subset of a group which contains at least one MIPS eligible clinicians and is identified by a combination of the group Taxpayer Identification Number (TIN), the subgroup identifier, and each eligible clinician’s National Provider Identifier (NPI).” Anesthesiologists who participate in MIPS with non-anesthesiologists may be able to report the anesthesia MVP. Please check with your group administrator or CMS for eligibility requirements.

What are the differences between Traditional MIPS and MVPs?

Anesthesiologists and their groups may report either Traditional MIPS or the Anesthesia MVP in 2026. The table below includes some considerations when choosing whether to report one or the other.

Performance Year 2025:

Eligible clinicians and their groups will need to choose four measures from this designated list:

• Q404: Anesthesiology Smoking Abstinence
• Q424: Perioperative Temperature Management
• Q430: Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy
• Q463: Prevention of Post-Operative Vomiting (POV) - Combination Therapy (Pediatrics)
• Q477: Multimodal Pain Management
• Q487: Screening for Social Drivers of Health 
• AQI48: Patient-Reported Experience with Anesthesia
• ABG44: Low Flow Inhalational General Anesthesia
• ePreop31: Intraoperative Hypotension (IOH) Among Non-Emergent Noncardiac Surgical Cases

Eligible clinicians and their groups also have a set of twelve (12) improvement activities to choose:

• IA_BE_6: Regularly Assess Patient Experience of Care and Follow Up on Findings
• IA_BE_22: Improved practices that engage patients pre-visit
• IA_BMH_2: Tobacco use
• IA_CC_2: Implementation of improvements that contribute to more timely communication of test results
• IA_CC_15: PSH Care Coordination
• IA_CC_19: Tracking of clinician’s relationship to and responsibility for a patient by reporting MACRA patient relationship codes
• IA_MVP: Practice-Wide Quality Improvement in MIPS Value Pathways
• IA_PCMH: Electronic submission of Patient Centered Medical Home accreditation.
• IA_PM_26: Vaccine Achievement for Practice Staff: COVID-19, Influenza, and Hepatitis B
• IA_PSPA_1: Participation in an AHRQ-listed patient safety organization
• IA_PSPA_7: Use of QCDR data for ongoing practice assessment and improvements
• IA_PSPA_16: Use of decision support and standardized treatment protocols

For more information, please contact ASA Department of Quality and Regulatory Affairs at qra@asahq.org.