2026 Medicare pay: Check your remittance advices

Performance year 2024 Medicare Merit-based Incentive Payment System (MIPS) payment adjustments are now appearing in 2026 Medicare reimbursements.

• The CAP Pathologists Quality Registry (PQR) has received reports that some Centers for Medicare & Medicaid Services (CMS) MIPS payment adjustments may be applied incorrectly. 

The impact: This may affect pathologists who participated in MIPS and continue billing Medicare.

• Some practices with high 2024 scores appear to be receiving neutral or negative adjustments instead of the positive adjustments they earned.
• Incorrect CMS payment adjustments could result in Medicare underpayments or overpayments in 2026.

What to check: Review your 2026 remittance advice (electronic or paper) and look for the Claim Adjustment Reason Code (CARC).

• Positive payment adjustments are indicated by CARC 144: “Incentive adjustment, e.g., preferred product/service.”
• Negative payment adjustments are indicated by CARC 237: “Legislated/Regulatory Penalty. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).”
• You may also see Remittance Advice Remark Code (RARC) N807, which indicates that a MIPS payment adjustment applies but does not specify whether it is positive or negative.

Next steps: Confirm that your 2026 payment adjustment matches your official MIPS results.

• Log in to your QPP account at qpp.cms.gov.
• Select "Performance Feedback."
• Choose “Performance Year 2024” from the dropdown menu.
• Review your final score and payment adjustment, including any approved Targeted Review.

If the adjustment on your remittance advice does not match your final score or approved Targeted Review outcome, contact the CAP immediately.

Need help? 

• Email registry.inquiries@cap.org if you believe your MIPS payment adjustment is incorrect.
• The CAP is actively working to ensure practices receive the Medicare payments they earned.