2026 MIPS Payment Adjustments Have Been Released!
The Centers for Medicare and Medicaid Services (CMS) has released 2026 MIPS payment adjustment information. These payment adjustments are tied to 2024 MIPS scores and will be reflected on Medicare Part B physician service reimbursements with dates of service starting January 1, 2026.
How Are Payment Adjustments Determined?
Payment adjustments are tied to scores from the MIPS performance year two years prior to the payment year (e.g., 2026 payment adjustments reflect 2024 MIPS scores). MIPS is a budget neutral program, so negative adjustments (penalties) and positive adjustments (bonuses) must be balanced. Thus, the funds for bonuses come from the pool of penalty dollars.
This means that the size of your payment adjustment depends not only on your performance, but also on the distribution of scores of everyone else participating in MIPS. Because of this, the bonuses for the same MIPS Final Score will vary year-to-year.
The table below illustrates how your 2024 MIPS score relates to your 2026 payment adjustment.
| 2024 MIPS Final Score | 2026 MIPS Payment Adjustment |
| 0.00 – 18.75 points | Penalty of -9% |
| 18.76 – 74.99 points | Penalty between -9% and 0%, calculated using a linear sliding scale |
| 75.00 points (equal to the performance threshold) | Neutral payment adjustment (0%) |
| 75.01 – 100.00 points | Bonus (adjustment greater than 0%), calculated using a scaling factor to preserve budget neutrality* |
For more information, refer to CMS’ 2026 MIPS Payment Adjustment User Guide (PDF).
*Note: Bonuses may change after the targeted review period if there are substantial changes in score distributions.
How Do I See My Payment Adjustment?
You can access your 2026 MIPS payment adjustment the same way you access your 2024 MIPS score:
- Sign in to your QPP account.
- Click on “Performance Feedback” on the left-hand navigation.
- Click on the carat next to “Download Data”.
- In the dropdown that appears, click “Payment Adjustment.CSV”. This will give you a report that includes final score and payment adjustment information for all clinicians in your practice.
What If There’s an Error in My Final Score or Payment Adjustment?
If you feel that your 2024 MIPS final score or 2026 payment adjustment is incorrect due to a calculation error on CMS’ part, you can appeal your score and/or payment adjustment. CMS calls these appeals “targeted reviews”. You can submit a targeted review through your QPP account.
The deadline to submit a targeted review request is November 14, 2025, at 8 pm ET.
Appropriate reasons to submit a targeted review include (but are not limited to) the following:
- You qualify for an automatic hardship for one or more categories (and did not submit data for those categories) but were not granted the hardship.
- You qualify for QP status and should not have received a MIPS payment adjustment.
- Data was submitted under the wrong TIN or NPI.
Be aware that targeted review decisions, whether favorable or unfavorable, are final. For more information, refer to CMS’ 2024 MIPS Targeted Review User Guide (PDF).
If you are an Anatomy IT client, we can assist you with requesting a targeted review.
Next Steps
- Share this information with your colleagues.
- Subscribe to our blog to get alerts on this and other important issues. You can subscribe using the field in our website footer below.
- If you are an Anatomy IT client, contact your MIPS Expert if you have any questions.
- If you are not an Anatomy IT client, contact us to learn more about our MIPS Success Plan and to reap the rewards of our combined decades of experience.
Written By: Sarrah Hakim, MHSA
About the Author: Sarrah is a Manager of Health Policy at Anatomy IT.
