What's New in 2026
This page summarizes substantive changes to the traditional MIPS program as they apply to optometry and ophthalmology. The information presented here is not intended to be comprehensive. Refer to the individual measure topics for specifics. Here's what's new this performance year:
General Changes
- Beginning in 2025, optometrists and op hthalmologists became eligible—but not required—to participate in the Participating in MVP (MIPS Value Pathways) program. The MVP program is still optional for optometrists and ophthalmologists in 2026, but Encompass now supports MVP.
Quality Changes
- Claims-based reporting for 141. Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 20% or Documentation of a Plan of Care is no longer topped out. This means this reporting method is no longer capped at a maximum of 7 points.
- Registry reporting for 141. Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 20% or Documentation of a Plan of Care is now topped out. This reporting method is capped at a maximum of 7 points.
- AAO IRIS registry reporting is no longer available for 236. Controlling High Blood Pressure.
- Registry reporting is now available for 238. Use of High-Risk Medications in Older Adults.
- Registry reporting for 317. Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented is no longer topped out. This means this reporting method is no longer capped at a maximum of 7 points.
- Encompass now supports MVP reporting for the following measures:
- 012. Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
- 019. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
- 117. Diabetes: Eye Exam
- 130. Documentation of Current Medications in the Medical Record
- 141. Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 20% or Documentation of a Plan of Care
- 191. Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
- 226. Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
- 303. Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery
- 304. Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery
- 374. Closing the Referral Loop: Receipt of Specialist Report
- 384. Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating Room Within 90 Days of Surgery
- 385. Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement within 90 Days of Surgery
- 389. Cataract Surgery: Difference Between Planned and Final Refraction
- 499. Appropriate Screening and Plan of Care for Elevated Intraocular Pressure Following Intravitreal or Periocular Steroid Therapy
- 500. Acute Posterior Vitreous Detachment Appropriate Examination and Follow-up
- 501. Acute Posterior Vitreous Detachment and Acute Vitreous Hemorrhage Appropriate Examination and Follow-up
- 503. Gains in Patient Activation Measure (PAM) Scores at 12 Months
Promoting Interoperability Changes
- For the High Priority Practices Guide of the Safety Assurance Factors for EHR Resilience (SAFER) Guides measure, you're now required to use the 2025 High Priority Practices SAFER Guide. Previously, you could rely on older versions of the SAFER guide.
- CMS updated the Security Risk Analysis measure to include a second attestation. Clinicians must now also attest “Yes” or “No” to having conducted security risk management activities as required under the risk management component of the HIPAA Security Rule. The measure remains required, and a “No” response will to result in a total score of zero points for the Promoting Interoperability performance category.
- CMS added a new optional public health measured called Public Health Reporting Using the Trusted Exchange Framework and Common Agreement (TEFCA).
Improvement Activities Changes
- CMS renamed the Advancing Health Equity (AHE) category to Advancing Health and Wellness (AHW).
- Of the activities Eyefinity recommends, CMS removed the following:
- Create and Implement a Plan to Improve Care for Lesbian, Gay, Bisexual, Transgender, and Queer Patients (IA_AHE_11)
- Vaccine Achievement for Practice Staff: COVID-19, Influenza, and Hepatitis B IA_PM_26
Cost Changes
- New Cost measures now undergo a two-year informational feedback period before being fully implemented. This means that new cost measures will not impact your MIPS performance for the first two years. This two-year period allows everyone time to see how the measures impact their performance.