The 2026 Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception application is available now through December 31, 2026, at 8 p.m. ET. This application allows users to indicate the reason they’re unable to report data for one or more MIPS performance categories.   

Individual clinicians, groups, and virtual groups (or a third-party representative) can submit a MIPS Extreme and Uncontrollable Circumstances (EUC) exception application for one or more MIPS performance categories (quality, cost, improvement activities, and Promoting Interoperability) due to extreme and uncontrollable circumstances, defined as rare events entirely outside of your control and the control of the facility in which you practice.  

These circumstances would:  

• Cause you to be unable to collect information necessary to submit for a MIPS performance category.  

• Cause you to be unable to submit information that would be used to score a MIPS performance category for an extended period of time (for example, if you were unable to collect data for the quality performance category for 3 months).  

• Impact your normal processes, affecting your performance on cost measures and other administrative claims measures.  

Alternate Payment Model (APM) Entities participating in a MIPS APM can submit applications as well, but they must apply for all performance categories.  

If your application is approved, you won’t be required to report data for the performance category or categories included in your approved application. Please note, however, that a qualifying data submission will override approved reweighting on a category-by-category basis. We’ll score any qualifying data that you, or someone on your behalf, submits, and those performance categories will contribute to your final score.  

How to Apply  

• Sign in to the QPP website with your Health Care Quality Information System (HCQIS) Access Roles and Profile (HARP) account.  

• Choose “Exceptions Application” from the left-hand navigation.  

• Click “Add New QPP Exception” on the right side of the screen.  

• Choose “Extreme and Uncontrollable Circumstances Exception.”  

Additional Resources  

• Quality Payment Program Access User Guide (ZIP, 5MB) — Refer to “Step 1: Register for a HARP Account.” 

• Exception Applications (webpage on the QPP website) 

• 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide (PDF, 2MB)  

2026 MIPS Value Pathways (MVPs) Registration Open    

The MVPs registration window is open for the 2026 performance year. Individuals, groups, subgroups, and Alternative Payment Model (APM) Entities that want to report an MVP can register until November 30, 2026.   

*Note: If the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey is an available measure in your selected MVP and you want to administer it as 1 of your 4 required measures, you‘ll need to complete both your MVP registration and a separate CAHPS for MIPS Survey registration by June 30, 2026, at 8 p.m. ET.    

Prepare for MVP Registration   

To help you prepare for MVP registration, please refer to the 2026 Finalized MVPs Guide (PDF, 1MB).   

Want to learn more about the available MVPs for the 2026 performance period? Visit the Explore MVPs page.   

How to Register   

Individuals, groups, subgroups, and APM Entities will register on the QPP website. You’ll need to have the Security Official role to register your organization. Please refer to the QPP Access User Guide (ZIP, 5MB) for information about obtaining a Security Official role for your organization.  

Who doesn’t need to register?   

• Medicare Shared Savings Program Accountable Care Organizations (ACOs)   

• These ACOs are required to report through the APP so they’re automatically registered for the CAHPS for MIPS Survey, which is required under the APP.   

• These ACOs don’t need to register but will still need to hire a CMS-approved vendor to administer the CAHPS for MIPS Survey.    

Who must register?  

• Groups and APM Entities (other than Shared Savings Program ACOs) that choose to report through the APP must register because the CAHPS for MIPS Survey is a required measure under the APP  

Who can register?   

• Groups, virtual groups, and APM Entities that intend to administer the CAHPS for MIPS Survey as 1 of their 6 quality measures for reporting traditional MIPS   

• Groups, subgroups, and APM Entities that are registered to report the following MVPs and that intend to administer the CAHPS for MIPS Survey as 1 of their 4 quality measures 

How to Register   

Groups, virtual groups, and APM Entities will register on the QPP website. You’ll need to have the Security Official role to register your organization. Please refer to the QPP Access User Guide (ZIP, 5MB) for information about obtaining a Security Official role for your organization.  

Registration closes June 30, 2026 at 8 p.m. ET.   

Additional Resource  

• 2026 CAHPS for MIPS Survey Registration Guide (PDF, 1MB)