Final 2025 MIPS Eligibility Officially Updated: What You Need to Know

Final 2025 MIPS eligibility has officially been updated, and this year, the details matter more than ever.

At KRK Value-Based Consultants, we’re already walking our partners through the newest CMS updates, and we wanted to highlight a few immediate action steps every practice should take as we wrap up the 202 performance year and prepare for 2026.

1. Re-check your 2025 MIPS eligibility status

Even if you checked earlier this year, your status may have changed based on the latest Medicare Part B claims and PECOS data.

Use the QPP Participation Status Tool and confirm eligibility at every TIN you’re associated with.

A few important nuances:

• Clinicians who joined a new practice between Oct 1, 2024 – Sept 30, 2025 must re-check eligibility under their new TIN.

• If you were initially ineligible, your status won’t change. But if you were initially eligible, you may now be ineligible or opt-in eligible.

2. Check your initial 2026 eligibility now

2026 may feel far away, but your eligibility is available today — and your performance next year determines your 2028 payment adjustment.

Use the QPP tool, enter your NPI, and treat this as your head start.

CMS will release final 2026 eligibility in December 2026, but your preparation starts now.

3. Prepare for the 2025 data submission period (opening Jan 2, 2026)

CMS is already projecting extended wait times for the QPP Service Center once the submission window opens, so KRK is strongly recommending two things:

✔ Make sure your HARP account is active

If you haven’t logged in recently, check access now, reset passwords, and confirm your QPP roles.

✔ Submit early

Don’t wait until March. Early submission means fewer delays and more time to troubleshoot if needed.

Tip: CMS asks that practices use only one method of communication (email, phone, or ticket) for each issue to prevent backlogs.

The KRK Perspective:

The practices that win under MIPS aren’t the ones who scramble in March.

They’re the ones who:

✔ Check eligibility early

✔ Understand their reporting paths

✔ Stay ahead of the deadlines

✔ Use MVPs strategically

✔ And treat MIPS as a year-round operational rhythm — not an annual fire drill

If your practice is unsure how these updates affect your MVP participation, subgroup strategy, opt-in decisions, or performance planning, KRK is here to guide you through the data, the decisions, and the details that protect revenue.

If you want help interpreting your 2025 or 2026 eligibility status, send me a message.

We’re currently walking groups, PE-backed networks, and multi-specialty organizations through these updates — and aligning them with smart strategies for 2025 and beyond.