This document is a technical report detailing the proposed changes to the Merit-based Incentive Payment System (MIPS) measures that are expected to take effect in 2026. It outlines significant modifications across various categories, including Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost. Key changes include the maintenance of a 75-point threshold to avoid penalties, a deprioritization of health equity measures, and the introduction of new MIPS Value Pathways (MVPs). The report also discusses specific proposed changes to existing quality measures, including updates to the definitions and criteria for several specialties such as dermatology, ophthalmology, orthopedic surgery, and more. Additionally, it highlights the proposed removal of certain measures that are now considered standard care, reflecting an ongoing evolution in healthcare quality metrics. The document serves as a comprehensive guide for stakeholders to understand the implications of these changes.