The Improvement Activities (IA) category requires a pathologist or group to attest to completing a certain number of CMS-approved activities over the course of the year, with each activity taking place over at least 90 continuous days. This category will count for 15% of the overall MIPS final score for large practices and 50% of the overall MIPS final score for small practices.
For MIPS reporting, only an attestation is required to receive points for completing Improvement Activities. However, in the event of an audit, practices will need to ensure they have documentation confirming the completion of the activity.
Important 2026 Updates: CMS has removed two IAs applicable that were highly used by pathologists and three more that some practices reported
- IA_CC_1: Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop
- IA_CC_2: Implementation of Improvements that Contribute to More Timely Communication of Test Results
- IA_AHE_8: Create and Implement an Anti-Racism Plan
- IA_ERP_3: COVID-19 Clinical Trials
- IA_PM_26: Vaccine Achievement for Practice Staff: COVID-19, Influenza, and Hepatitis B
CMS has removed the “Advancing Health Equity (AHE)” Improvement Activity subcategory for 2026. Some activities that were part of this subcategory, such as IA_AHE_6, Provide Education Opportunities for New Clinicians, are still available as part of a different subcategory. Other AHE activities, such as IA_AHE_8, Create and Implement an Anti-Racism Plan, have been eliminated.
CMS has introduced a new subcategory for 2026, Advancing Health and Wellness. However, there is only one IA in this category, IA_AHW_1, Chronic Care and Preventative Care Management for Empaneled Patients. This IA is not applicable to most pathology practices.
Available Activities
We have developed a resource to help pathologists participating in MIPS determine which Improvement Activities to attest to in 2026. To receive credit in this category, pathologists need to attest to Improvement Activities, which represent 15% of their final MIPS score if they are in a large practice and 50% of their final MIPS score if they are in a small practice.
Attesting and Submitting Activities
Participants in the Pathologists Quality Registry can attest to Improvement Activities using the MIPS Portal. Those who choose to submit using Medicare Part B claims or other registries can attest to Improvement Activities using the log in and attest submission method on the CMS website.