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Summary: The value-based care programs that affect physical therapy in 2026 (MIPS and the Rehabilitative Support for Musculoskeletal Care MVP, SNF VBP, PDPM, the CMS ACCESS Model and remote therapeutic monitoring), how outpatient and SNF requirements differ, the six EMR capabilities value-based care needs, MVP quality measures, an EMR shortlist by setting, how SPRY supports outpatient value-based care, and an EMR value-based care readiness scorecard.
The best EMR for value-based care in physical therapy is one that collects outcome measures automatically, reports MIPS quality measures, tracks Medicare rules in real time and shares data through a certified FHIR API, so payment programs reward your results instead of penalizing missing data. For outpatient PT, OT and SLP, that means MIPS and the Rehabilitative Support for Musculoskeletal Care MVP (M1370), with payment adjustments of up to ±9%. For skilled nursing facilities, it means MDS accuracy, PDPM coding and the SNF Value-Based Purchasing program. Outpatient platforms such as SPRY focus on the first; SNF teams also need a long-term care EHR with MDS support.
Below: the 2026 value-based programs that affect therapy, outpatient vs SNF requirements, six EMR capabilities to check, MVP quality measures, an EMR shortlist by setting, a readiness scorecard and FAQs.
Value-based care programs that affect physical therapy in 2026
| Program | Setting | What it rewards or measures | What's at stake |
|---|---|---|---|
| MIPS (Quality Payment Program) | Outpatient PT, OT and SLP above the low-volume thresholds ($90,000, 200 patients or 200 services) | Quality, Promoting Interoperability (25%), improvement activities and cost; 75-point performance threshold | Up to ±9% on Medicare Part B payments; 2026 performance sets 2028 payments |
| MSK MVP (M1370) | Outpatient PT, OT, chiropractic and physiatry | Functional status change, functional outcome assessment, falls, depression screening and MSK pain measures | Simpler MIPS reporting built around therapy measures |
| SNF Value-Based Purchasing | Skilled nursing facilities | Quality measures such as readmissions; eight measures in the FY 2027 program year | 2% of Medicare Part A payments withheld, 60% paid back as incentives; CMS estimated $208.36 million in net reductions for FY 2026 |
| PDPM | Skilled nursing facilities | Case mix from MDS data and ICD-10 coding | 34 PDPM ICD-10 mapping changes finalized for FY 2026 |
| ACCESS Model (CMS Innovation Center) | Medicare Part B-enrolled providers and suppliers, with an MSK track | Patients meeting condition-specific improvement targets | Outcome-aligned payments; first performance period began July 1, 2026 |
| Remote therapeutic monitoring | Outpatient therapy | Monitoring between visits | New 2026 codes include 98985 and 98979 |
Sources: CMS Quality Payment Program, 2026 MVP M1370 measures, CMS FY 2026 SNF PPS final rule fact sheet, CMS SNF VBP program, ACCESS Model summary and the CMS 2026 therapy code list.
Outpatient vs SNF: what your EMR has to handle
| Need | Outpatient PT, OT and SLP | Skilled nursing facility |
|---|---|---|
| Main program | MIPS or the MSK MVP | SNF VBP, SNF QRP and PDPM |
| Data that drives payment | PROMs and quality measures on Part B claims | MDS assessments, Section GG function and ICD-10 coding |
| Must-have EMR features | Automated PROMs, MIPS reporting, KX and progress report tracking, RTM | MDS integration, PDPM mapping, therapy minutes and readmission tracking |
| Typical systems | Outpatient therapy EMRs such as SPRY, WebPT, Raintree and Prompt | Long-term and post-acute care EHRs such as PointClickCare and MatrixCare |
Organizations that run both settings usually pair an outpatient therapy EMR with the facility's long-term care EHR and connect them through interfaces or FHIR APIs.
Six EMR capabilities value-based care needs
1. Automated outcome measures
PROMs only count if they are collected consistently. The EMR should send questionnaires at intake, re-evaluation and discharge, score them automatically and link them to the episode. SPRY offers 50+ configurable outcome measures, including LEFS, FOTO and DASH, collected before the visit and tracked across the episode of care.
2. MIPS and MVP reporting
For the 2026 performance year the MIPS performance threshold is 75 points, and quality data must meet the 75% data completeness requirement. The MSK MVP gives therapists a focused measure set:
| Quality ID | Measure |
|---|---|
| 182 | Functional Outcome Assessment |
| 217–222, 478 | Functional Status Change for knee, hip, lower leg/foot/ankle, low back, shoulder, elbow/wrist/hand and neck impairments |
| MSK6–MSK9 | Patients with neck, upper extremity, back or lower extremity injuries who improve pain |
| 155 | Falls: Plan of Care |
| 134 | Preventive Care and Screening: Screening for Depression and Follow-Up Plan |
| 128 | Preventive Care and Screening: BMI Screening and Follow-Up Plan |
| 050 | Urinary Incontinence: Plan of Care for Women Aged 65 and Older |
SPRY includes MIPS reporting in its billing service. For certified EHR and Promoting Interoperability rules, see EHR requirements for therapists.
3. Medicare rule tracking
Value-based programs sit on top of everyday Medicare rules. For 2026, the EMR should track the $2,480 KX threshold for PT and SLP combined and for OT, progress reports at least every 10 treatment days and plan of care certification. SPRY's integrated billing rule engine and claim scrubbing check claims before they go out.
4. Remote therapeutic monitoring
RTM lets you bill for monitoring between visits. CMS added new 2026 codes, including 98985 for musculoskeletal device supply over 2 to 15 days and 98979 for the first 10 minutes of treatment management. Read more about remote therapeutic monitoring.
5. FHIR interoperability
ACOs, the ACCESS Model and payer partnerships all depend on sharing data. ONC-certified EHRs are tested against federal criteria, including a standardized FHIR API; ask vendors which criteria their certification covers. SPRY is an ONC-certified EHR; see SPRY integrations.
6. Revenue cycle automation
Clean claims and accurate authorizations protect margins under any payment model. Look for real-time eligibility, prior authorization tracking, claim scrubbing and denial follow-up. The Therapy Network reported 98% clean claims on first submission and roughly one-third fewer denials after moving to SPRY (Healthcare IT News). See PT software with integrated RCM.
EMR shortlist for value-based care by setting
| Your organization | EMRs to evaluate | What to verify in a demo |
|---|---|---|
| Outpatient clinic or group | SPRY, WebPT, Raintree, Prompt | Automated PROMs, MVP measure reporting, data completeness and RTM billing |
| Skilled nursing facility | PointClickCare, MatrixCare | MDS and Section GG workflow, PDPM mapping and QRP reporting |
| Both settings | An outpatient therapy EMR plus the facility's long-term care EHR | How referrals, outcomes and discharge data move between the two |
SPRY
SPRY is built for outpatient PT, OT and SLP. It combines 50+ outcome measures, documentation with an AI Scribe on the Plus plan, an integrated billing rule engine, eligibility checks, Fax AI and a billing service that includes prior authorization and MIPS reporting. It is ONC-certified, rated 4.8 on G2 and Capterra, and was ranked #1 for physical and occupational therapy by Black Book Research in 2026. SPRY is not an MDS system for SNF Part A stays.
WebPT
WebPT serves outpatient rehab therapy and added outcomes tracking when it acquired Keet in January 2022, alongside Clinicient. It sells Starter, Enhanced and Ultimate plans, with advanced analytics in Ultimate. See WebPT alternatives and PT EMR pricing compared.
EMR value-based care readiness scorecard
EMR value-based care readiness scorecard
Choose your setting, then tick each capability your current or shortlisted EMR has. The scorecard shows your readiness score and the gaps to raise with vendors.
This scorecard is a planning aid based on 2026 CMS program requirements. It is not a MIPS score estimate. This tool does not store any data.
For background on how payment is shifting, read value-based care is coming to physical therapy, and compare full feature sets in the PT EMR buyer's guide.
Frequently asked questions
What is the best EMR for value-based care in physical therapy?
For outpatient PT, OT and SLP, choose an EMR that automates outcome measures, reports MIPS and MVP quality measures, tracks Medicare rules and has a certified FHIR API; SPRY, WebPT, Raintree and Prompt are common shortlist options. SNFs also need a long-term care EHR with MDS and PDPM support.
What is the best software for MIPS reporting for physical therapists?
Look for software that captures MSK MVP measures during documentation, shows data completeness against the 75% requirement and submits to CMS. SPRY includes MIPS reporting in its billing service.
What are the 2026 MIPS threshold and penalty?
The 2026 performance threshold is 75 points. Payment adjustments range up to ±9% and apply to Medicare Part B payments in 2028, based on 2026 performance. Clinicians at or below the low-volume thresholds of $90,000, 200 patients or 200 services are excluded.
Which MVP should physical therapists use?
The Rehabilitative Support for Musculoskeletal Care MVP (M1370) is designed for physical therapy, occupational therapy, chiropractic and physiatry. Its quality measures include functional outcome assessment, functional status change by body region and MSK pain improvement.
What does an EMR need for SNF value-based care?
SNF value-based care depends on accurate MDS assessments, Section GG function scores, PDPM ICD-10 coding and tracking of SNF QRP and VBP measures such as readmissions. These usually live in a long-term care EHR such as PointClickCare or MatrixCare.
What PDPM changes took effect for FY 2026?
CMS finalized 34 changes to PDPM ICD-10-CM code mappings in the FY 2026 SNF PPS final rule, along with a 3.2% SNF payment update.
What is the CMS ACCESS Model?
ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) is a 10-year CMS Innovation Center model announced in December 2025. It pays Medicare Part B-enrolled providers for patients who meet improvement targets in tracks that include musculoskeletal conditions, with the first performance period starting July 1, 2026.
What is the best FHIR-compliant PT management software?
Choose an ONC-certified EHR and confirm its certification covers the standardized FHIR API. SPRY is an ONC-certified EHR for outpatient PT, OT and SLP.
What digital tools support value-based care in physical therapy?
Automated PROMs, remote therapeutic monitoring, home exercise programs, patient reminders and messaging, outcome dashboards and MIPS reporting all help therapists show and improve results.
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Get a DemoLegal Disclosure:- Comparative information presented reflects our records as of Nov 2025. Product features, pricing, and availability for both our products and competitors' offerings may change over time. Statements about competitors are based on publicly available information, market research, and customer feedback; supporting documentation and sources are available upon request. Performance metrics and customer outcomes represent reported experiences that may vary based on facility configuration, existing workflows, staff adoption, and payer mix. We recommend conducting your own due diligence and verifying current features, pricing, and capabilities directly with each vendor when making software evaluation decisions. This content is for informational purposes only and does not constitute legal, financial, or business advice.
