On February 8, 2023, your Academy submitted comments regarding a proposed new Merit Based Incentive Payment System (MIPS) Value Pathway (MVP) for Musculoskeletal Care and Rehabilitative Support. This new MVP is under consideration for the 2024 reporting year. Our comment highlights overall concerns about the ability for the proposed MVP to offer a clinically coherent participation pathway for physiatrists. Further, your Academy has reservations about this MVP using the new Low Back Pain cost measure, which has not been approved for inclusion in the MIPS program yet. While this new cost measure has been field tested, AAPM&R contests that its inclusion in an MVP for performance year 2024 would be premature. For additional information on current Medicare quality reporting requirements, please visit the Academy website.