Now Available: Updated 2026 CMS QRDA III Implementation Guide (IG) for Eligible Clinicians for the 2026 Medicare PFS Final Rule

The Centers for Medicare & Medicaid Services (CMS) has released the updated 2026 CMS Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG) for the Eligible Clinician program, reflecting changes finalized in the 2026 Medicare Physician Fee Schedule (PFS) Final Rule published on October 31, 2025.

The updated QRDA III IG provides detailed requirements for Eligible Clinicians (ECs) to report electronic clinical quality measures (eCQMs) for Calendar Year (CY) 2026 quality reporting programs.

The updated 2026 CMS QRDA III IG contains these high-level changes based on the PFS Final Rule:

• Table 4: Addition of 6 new Merit-based Incentive Payment System (MIPS) Value Pathway (MVP) Identifiers
  • Diagnostic Radiology
  • Interventional Radiology
  • Neuropsychology
  • Pathology
  • Podiatry
  • Vascular Surgery
• Table 17: Addition of Universally Unique Identifiers (UUIDs) for 2 new eCQMs
  • CMS1173v1: Diagnostic Delay of Venous Thromboembolism in Primary Care
  • CMS1154v1: Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing Diabetes
• Table 18: Improvement Activities (IA) updates
  • 8 Removals
  • 7 Modifications
  • 3 New IAs
• Table 19: Addition of 1 new (bonus) Promoting Interoperability (PI) measure
  • Public Health Reporting Using Trusted Exchange Framework and Common Agreement (TEFCA) within the Public Health and Clinical Data Exchange Objective.

There were no changes to the 2026 CMS QRDA III Schematron and Sample Files.

Additional QRDA-Related Resources:

• To find out more about QRDA and eCQMs, visit the Electronic Clinical Quality Improvement (eCQI) Resource Center.
• For questions related to the QRDA Implementation Guides and/or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.
• See the QRDA Known Issues Dashboard for solutions under development for both QRDA I and III known technical issues. These known issues supplement the information in QRDA IGs and other supporting documents.