MIPS MVPs in 2026: the 27-MVP catalog, why Value in Primary Care is the right pick for most small practices, and a 6-step switch playbook

Q: How does subgroup reporting work in an MVP?

MVPs support subgroup reporting — you can report performance for a specific subset of clinicians within your TIN (e.g. just the primary-care physicians, excluding specialists). This is useful for multi-specialty groups where one MVP doesn't fit everyone. Subgroup reporting requires registering each subgroup separately at qpp.cms.gov. For a 3-provider RHC where everyone does primary care, subgroup is unnecessary — just report the whole TIN.

Q: What happens if I register for an MVP but miss the performance threshold?

Same as traditional MIPS — your composite score determines a positive or negative payment adjustment 2 years later. You don't get penalized for choosing an MVP per se; the score-based adjustment math is identical. The risk of switching is operational: the first MVP year requires a learning curve. But most practices report first-year MVP scores higher than their last traditional-MIPS year, even with the learning curve.

Switching from traditional MIPS to a Value Pathway typically raises a small practice's composite score by 5-10 points. Here's the verified PY2026 catalog (27 MVPs), the Value in Primary Care measure set, decision criteria, and the 6-step switch playbook.

By Anthony Pinto · Founder, Triad Health Engine · Published 2026-04-19 · 10-min read

The short answer — MIPS Value Pathways are pre-built, clinically-coherent measure bundles that simplify MIPS reporting. CMS has finalized 27 MVPs in the PY2026 catalog (verified against the CMS QPP measures-data repository). Most are specialty-anchored — for small primary-care practices the dominant fit is Value in Primary Care (MVP ID M0005), with a 12-measure Quality bundle (you report a subset), a Foundational PI set, and an IA bundle anchored on PCMH + chronic-care management. Switching from traditional MIPS to an MVP typically raises a small-practice composite score by 5-10 points (the curated bundle removes the 'picked bad measures' trap). Combined with the 6-point small-practice bonus, many borderline-penalty practices flip into bonus territory just by switching pathway. Registration window: April 1 - December 1. Traditional MIPS still allowed in PY2026 but on the path to deprecation.

Frequently asked questions

What is a MIPS Value Pathway (MVP)?

A MIPS Value Pathway is a CMS-published, pre-built bundle of Quality measures + Promoting Interoperability requirements + Improvement Activities aligned to a specific clinical focus area (e.g. Primary Care, Heart Disease, Diabetes Care). Reporting through an MVP simplifies traditional MIPS by giving you a curated, internally-consistent measure set instead of asking you to pick six Quality measures from a 200+ option library.

How is an MVP different from traditional MIPS?

Traditional MIPS lets you pick any 6 Quality measures from a long list, plus any Improvement Activities, plus required Promoting Interoperability items. MVPs constrain those choices to a clinically-coherent bundle (e.g. the Primary Care MVP's 6 Quality measures all relate to primary-care outcomes). Practical effects: less choice paralysis, internal-consistency bonus, more accurate clinical-care benchmarking, and typically 5-10 composite-score points higher than traditional MIPS for small practices because the bundles avoid the "picked measures we don't actually do well" trap.

How many MVPs exist in 2026?

CMS has finalized 27 MVPs in the PY2026 catalog (verified against the CMS QPP measures-data repository, github.com/CMSgov/qpp-measures-data). The list spans primary care plus specialty-focused bundles (cardiology, oncology, kidney, neurology, mental health, dermatology, gastroenterology, urology, ophthalmology, ENT, pulmonology, surgical care, podiatry, vascular, radiology, and others). For most small + rural primary-care practices the dominant choice is the Value in Primary Care MVP (M0005). The other 26 are specialty-anchored — useful only if you have a meaningful specialist component.

Can a small practice still report traditional MIPS instead of an MVP?

Yes — for now. Traditional MIPS remains an option for PY2026, but CMS has signaled (via the QPP final rules) that traditional MIPS will be phased out over time, with MVPs becoming the default reporting pathway. The transition is voluntary in PY2026, encouraged in PY2027, and likely mandatory by PY2028-2029. Switching now means you're not scrambling at deadline.

When is the MVP registration deadline?

You must register your MVP selection at qpp.cms.gov between April 1 and December 1 of the performance year. Most practices register early in the year (April-June) to give the team time to operationalize the chosen bundle. Late registration is allowed through Dec 1 but limits the time you have to actually perform on the measures.

Which MVP should a small primary-care practice pick?

Value in Primary Care (MVP ID M0005) for almost every general primary-care practice. The PY2026 Quality bundle has 12 measures from which you report a subset: Diabetes A1c (Q001), Advance Care Plan (Q047), Depression Screening + Follow-up (Q134), Controlling High Blood Pressure (Q236), SUD Treatment Initiation/Engagement (Q305), CAHPS for MIPS (Q321), Statin Therapy for CVD (Q438), HIV Screening (Q475), PCPCM Patient-Reported Outcome (Q483), Adult Immunization Status (Q493), Preventive Care + Wellness composite (Q497), and Suicide Safety Plan (Q504). The IA bundle is heavy on patient experience + chronic care: PCMH participation (IA_PCMH), Chronic Care Management for empaneled patients (IA_AHW_1), Patient Portal Engagement (IA_BE_4), Million Hearts CVD standardization (IA_PM_25), and others. For RHCs the Value in Primary Care MVP pairs naturally with the existing G0511 chronic care management workflow.

How do MVP scores compare to traditional MIPS for small practices?

Empirically, small practices who switched from traditional MIPS to the Primary Care MVP saw composite scores rise 5-10 points on average in the first reporting year. The biggest driver: traditional MIPS allows picking measures where you score low (because you didn't realize they were dragging composite); MVPs limit you to a bundle that's pre-validated as internally coherent. Combined with the small-practice 6-point bonus, many small practices flip from borderline-penalty into bonus territory just by switching reporting pathway.

Does the small-practice MIPS bonus apply to MVP reporting?

Yes. The 6-point automatic small-practice composite bonus (TINs with <15 clinicians billing Medicare) applies regardless of whether you report traditional MIPS or an MVP. Combine the bonus with an MVP's typical 5-10 point uplift over traditional MIPS and a small RHC can move from 60-70 in traditional MIPS to 78-88 in MVP territory — well into bonus payout range.

How does subgroup reporting work in an MVP?

MVPs support subgroup reporting — you can report performance for a specific subset of clinicians within your TIN (e.g. just the primary-care physicians, excluding specialists). This is useful for multi-specialty groups where one MVP doesn't fit everyone. Subgroup reporting requires registering each subgroup separately at qpp.cms.gov. For a 3-provider RHC where everyone does primary care, subgroup is unnecessary — just report the whole TIN.

What happens if I register for an MVP but miss the performance threshold?

Same as traditional MIPS — your composite score determines a positive or negative payment adjustment 2 years later. You don't get penalized for choosing an MVP per se; the score-based adjustment math is identical. The risk of switching is operational: the first MVP year requires a learning curve. But most practices report first-year MVP scores higher than their last traditional-MIPS year, even with the learning curve.

How does Triad Rev help with MVP reporting?

Triad Rev pulls your QPP performance data + your CMS Medicare PUF + your problem list, surfaces which MVP your patient panel is best-suited for (usually Primary Care), and tracks the 6 Quality measures + PI thresholds + IA attestations against the MVP's bundle in real time. End-of-year submission is one click instead of a 4-week scramble. $499/mo, 90-day free pilot.