We are excited to announce that MUSIC4, a high priority, process measure is [Prostate Cancer (Active Surveillance/Watchful Waiting for Newly Diagnosed Low Risk Prostate Cancer Patients)] available for both Traditional MIPS and the Urology MVP, has achieved a historical benchmark for the MIPS 2026 performance period.

Table 1. Decile Distribution for MUSIC4 (2026)

*Source: 2026 Benchmark File

CMS scores clinicians by comparing their 2026 performance rate to the historical decile distribution derived from the 2024 MIPS data. Clinicians reporting MUSIC4 for the 2026 performance period can earn up to 10 points based on which decile their performance rate falls into. 

Achieving Benchmark Status

To achieve a historical benchmark, each year, enough eligible MIPS participants (i.e., at least 20 individual clinicians, groups, virtual groups, or APM Entities) must report on a measure, and that measure must meet data completeness and case minimum requirements (75% and 20 cases, respectively) and have a performance rate greater than 0%. 

Although the AQUA Registry has supported MUSIC4 for several years, 2026 is the first year in which it has achieved benchmark status.  This important milestone was made possible only because AQUA participants reported on the measure even when it did not have a benchmark.  This underscores the importance of reporting AQUA measures even if they are not worth points in a particular year. 

Tips for Improving Performance

Consider taking the following actions to improve your performance on MUSIC4 [(Prostate Cancer (Active Surveillance/Watchful Waiting for Newly Diagnosed Low Risk Prostate Cancer Patients)]:

• Ensure clinicians are aware that AUA guidelines strongly recommend active surveillance as the preferred management option for patients with low-risk prostate cancer.
• Review the most current specifications for the measure to ensure understanding and facilitate accurate documentation.
• Monitor performance using the AQUA dashboard. Use this tool to identify patterns of care that are suboptimal or highly variable.
• Work with clinicians to identify why performance is lower than desired. Then, craft and deploy appropriate interventions as early as possible. Examples include:
  • Ensuring complete and accurate documentation. Data completeness is a major factor in calculating MIPS scores and missing data can lower performance rates.
  • Revising workflows, as needed, to improve likelihood of adherence with guideline supported numerator actions. Consider integrating prompts and/or checklists.
  • Offering targeted clinician education on documentation and/or clinical action as needed.
• Interact with your AQUA Client Account Coordinator (CAC) and the AQUA Registry dashboard. These resources are included in your AQUA Registry membership and can assist you with finding solutions for your MUSIC4, or any other measure-related, concerns.

Additional Resources

Visit the following resources for more information.

• 2026 AQUA Benchmarks File

Decile information for all measures supported by the AQUA Registry for the 2026 performance period.

• 2026 AQUA Supported MVPs

Measure and activity requirements for each option.

• Advancing Cancer Care
• Focusing on Women’s Health
• Optimal Care for Patients with Urologic Conditions
• 2026 QCDR Measure Specifications

Specifications include important information for calculating measures exclusively available through AQUA Registry participation (i.e., numerator, denominator).

• 2026 CMS Quality Benchmarks File

Decile information for all measures available for the 2026 performance period.

• 2026 CMS Quality Benchmarks User Guide with Scoring Examples

Measure performance rate data and calculation examples.