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If you’ve been navigating the Merit based Incentive Payment System for a while, you already know the rules shift every year. For 2026, CMS has made some notable changes, especially around improvement activities for MIPS. Whether you’re a solo clinician or part of a larger group practice, understanding this performance category could make a real difference in your final score and, ultimately, your Medicare reimbursement.
Let’s break all this information down in easy and understandable ways for you to get more idea about improvement activities for MIPS.
What Are Improvement Activities for MIPS?
The Improvement Activities (IA) category is one of four performance categories that make up your total MIPS score. It specifically measures whether clinicians are actively working to improve how they deliver care, things like care coordination, patient engagement, and patient safety practices.
This category accounts for 15% of your overall MIPS score for most clinicians. However, for small practices that don’t report Promoting Interoperability (PI) data, that weight can jump to 30%, making it an even bigger deal.
CMS maintains a library of over 100 eligible improvement activities for MIPS reporting, organized into subcategories like:
- Care Coordination (CC) – Closing referral loops, coordinating between providers
- Beneficiary Engagement (BE) – Post visit surveys, chronic condition care plans, patient reported outcomes
- Patient Safety and Practice Assessment (PSPA) – Safety protocols, EHR resilience
- Achieving Health Equity (AHE) – Engaging underserved populations, language access plans
- Behavioral and Mental Health (BMH) – Addressing the overlap of mental and physical health conditions
- Expanded Practice Access (EPA) – Improving patient access to care, after hours availability
There are activities relevant to virtually every specialty, so most clinicians can find something that aligns with how they already practice.
What’s New in 2026?
This is where things have actually gotten a bit simpler, which, in the world of MIPS reporting, is worth noting.
Starting with the 2026 performance year, CMS removed the old “high weighted” and “medium weighted” classification system for improvement activities. Previously, you’d need to hit a specific point threshold based on those weights. Now, all activities are treated equally.
Here’s what the new attestation requirements look like:
- MVP participants and special status clinicians (small practice, rural, non patient facing, or HPSA): Attest to 1 activity
- All other clinicians, groups, and virtual groups: Attest to 2 activities
Each activity must be performed for a minimum of 90 continuous days within the performance year. For group reporting, at least 50% of the clinicians under the same TIN must perform the same activity during that 90 day window.
Two new improvement activities were also added in 2026, including an MVP specific one titled “Practice Wide Quality Improvement in MIPS Value Pathways.”
How to Submit Improvement Activities for MIPS?
Understanding how to submit improvement activities for MIPS is just as important as selecting the right ones. The good news: the submission process itself is relatively straightforward, it’s attestation based, meaning you’re simply confirming that the activity was completed.
Here are the main submission channels CMS accepts:
- QPP website (manual attestation) – You can log in directly to the CMS Quality Payment Program portal and submit a “yes” response for each completed activity.
- Qualified Registry – A CMS approved registry submits on your behalf.
- Qualified Clinical Data Registry (QCDR) – Similar to a qualified registry, but often specialty specific.
- EHR system – Some certified EHRs have built in MIPS submission functionality.
No supporting documentation needs to be uploaded at the time of submission. However, CMS can audit practices for up to six years after the performance year, so keeping detailed records is non negotiable. Your documentation should include the activity’s start and end dates, a description of the process being improved, goals and outcomes, and any technology used.
Why Partnering With a MIPS Reporting Company Makes Sense?
Choosing the right improvement activities for MIPS, ones that fit your workflow and qualify under CMS guidelines, takes time and attention that most busy clinicians simply don’t have. That’s where dedicated MIPS reporting services come in.
We are a trusted MIPS reporting company that helps eligible clinicians and group practices manage every step of the process. From identifying the most appropriate improvement activities for your specialty and practice size, to ensuring timely, accurate submission through approved channels, their team handles the complexity so your focus stays on patient care.
We also helps practices stay ahead of annual rule changes, so you’re never caught off guard when CMS updates its requirements.
The Ending Note
Improvement activities for MIPS don’t have to be a burden. With the 2026 simplification of the weighting system and clearer attestation requirements, the process is more manageable than in previous years. The key is picking activities that genuinely reflect what your practice is already doing, performing them for the required 90 day window, and making sure your submission is accurate and on time.
If you want to take the guesswork out of the equation, working with a specialized MIPS reporting company like us can save you time, reduce risk of penalties, and help you maximize your final score.
Need help selecting and submitting improvement activities for MIPS? Contact us to learn how their MIPS reporting services can work for your practice.
