MIPS for ophthalmology continues to grow in complexity, and with the 2026 performance year on the horizon, practices that prepare early will be best positioned for seamless, successful reporting. The Merit-Based Incentive Payment System (MIPS), administered by the Centers for Medicare & Medicaid Services (CMS), is a value-based reimbursement program that ties a provider’s Medicare payments to their performance—directly influencing a practice’s financial outcomes. Ophthalmologists who delay preparation may miss opportunities to boost their score or avoid penalties. Conversely, early planning allows for better workflows, cleaner data, and stronger performance outcomes.
Whether your practice reports through Traditional MIPS, is considering MIPS Value Pathways (MVPs), or plans to opt in, understanding what to expect in 2026 is essential. In this blog, we’ll explore the key updates for MIPS 2026 and how ophthalmology practices can prepare for a successful year.
The structure of MIPS remains centered around four weighted categories. For the 2026 performance year, CMS will continue to score providers across Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost. Each of these plays a role in the final score, which determines payment adjustments.
In 2026, the category weights remain as follows:
Each category requires a different type of documentation and has its own reporting period. The Quality category spans the full year, while PI requires 180 consecutive days. IA typically requires 90 days of documentation. Cost is calculated from Medicare claims data.
The performance threshold in 2026 remains at 75 points. This means providers must score at least 76 points or higher to receive a positive payment adjustment.
MVPs continue to gain momentum as CMS moves away from Traditional MIPS. Although MVPs are still optional in 2026, ophthalmology practices should begin familiarizing themselves with the structure and plan their transition. MVPs involve reporting a more focused set of measures related to specific specialties or care models. CMS intends to make MVPs mandatory between 2027 and 2030.
You can visit the CMS website to get familiar with the Complete Ophthalmologic Care MVP, which assesses outcomes in glaucoma, cataract, retinal detachment, and ocular care.
A successful MIPS reporting year starts with organized planning and clearly defined responsibilities. When workflows are inconsistent, data collection suffers. Ophthalmology practices that standardize early are better positioned to submit accurate and complete data.
MIPS for ophthalmology is a team sport. Assign a MIPS team lead to oversee reporting in 2026. This person should lead data collection, documentation, and regular performance reviews. Then, document which team members are responsible for tracking each category and establish step-by-step procedures for collecting data in your EHR. It’s also important to include MIPS education and training in your new staff onboarding process. Clear ownership and understanding prevent costly mistakes and help keep reporting on track throughout the year.
Ideally, your MIPS team lead should review performance monthly. Monthly reviews uncover gaps, validate documentation accuracy, and identify issues in data mapping or EHR functionality. Keeping a close eye on your MIPS reporting throughout the year prevents the last-minute rush that often leads to mistakes. It also allows you to remediate any issues before they negatively impact your score.
Keep all MIPS-related files in one secure, backed-up location. Organize documents by category and use naming conventions that include measure names and dates. If CMS audits your submission, you will need quick access to comprehensive documentation.
Improvement Activities (IA) and Promoting Interoperability (PI) are often under-documented, which can put a practice at risk. These categories require specific evidence and careful planning to meet CMS standards.
For both IA and PI, documentation must be gathered during the performance period. Avoid waiting until year-end. For PI, save EHR screenshots, secure messaging logs, and access reports. For IA, gather training records, meeting notes, and evidence of implementation.
Quick Tip: Choose activities that align with changes that you have planned for your practice next year. For instance, if you are upgrading your EHR, select IAs related to Direct Messaging or Health Information Exchange. If your new EHR includes clinical decision support tools, those can also count as valid activities.
Ophthalmology practices should take a proactive approach to meeting the Promoting Interoperability (PI) criteria. In 2026, your practice must attest to completing the HIPAA Security Risk Analysis and using the latest SAFER Guide. It’s best to address this early in the performance year rather than waiting until the deadline.
If you use a certified EHR, verify with your vendor that:
Maintaining detailed documentation will help ensure your PI attestation goes smoothly.
If you are switching EHR systems, the timing can affect your PI performance. Plan transitions in Quarter 2 or 3 to allow for training and data continuity. Coordinate with your registry and maintain a paper trail of all communications related to integration and reporting setup.
The Quality category remains the most visible part of MIPS reporting. For traditional MIPS, practices must report on six selected measures for the entire performance year. Data completeness and accuracy are key to avoiding penalties and optimizing your score.
If using MVPs, keep in mind you will only report on four measures. This may streamline the reporting process, but measure selection becomes even more critical.
If your practice is changing EHR vendors, take steps to protect data from both systems. Run reports and take screenshots before discontinuing access to your old platform. Validate that your new system captures the required fields for your selected measures. Document all measure definitions and mappings.
Conduct a manual review of all final reports. Check that measures align with the correct performance period, that all documentation is complete, and that registry integrations are accurate. Submit at least two weeks ahead of the deadline to avoid last-minute errors.
MIPS is time-consuming, and mistakes can be costly. Practices that use expert tools and services reduce risk and improve performance. Whether you are managing reporting internally or working with a consultant, stay informed and proactive.
Managing MIPS for ophthalmology is far easier with an EHR that supports ophthalmology-specific measures and automates data tracking. Platforms like Sightview’s all-in-one solution help reduce manual entry and provide real-time feedback on performance. These tools allow practices to stay focused on patient care without losing control of MIPS compliance.
Set monthly reminders to check on data accuracy, measure progress, and documentation status, and conduct a more thorough midyear review to identify areas for course correction. Use our 2026 MIPS Toolkit to stay organized and ahead of deadlines.
MIPS reporting can be challenging, but you don’t have to navigate it alone. With over 80 years of combined experience, the Sightview MIPS team helps ophthalmology practices simplify reporting, maximize scores, and outperform the national average. Book a free consultation to see how we can help you succeed in 2026.
The 2026 performance year brings familiar expectations with a stronger push toward specialization and precision in reporting. MIPS for ophthalmology teams is not just about compliance. It reflects the operational health and clinical quality of your practice. Practices that plan early, document thoroughly, and monitor progress consistently are more likely to earn high scores and increase reimbursements.
Use the months ahead to align your team, review your workflows, and make informed decisions about your EHR and reporting strategies. By integrating MIPS into your daily workflows and leveraging the right tools and support, you can make 2026 your strongest year yet.
For more in-depth tips from our team, download our MIPS 2026 toolkit today.
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