The Centers for Medicare and Medicaid Services has released the calendar year (CY) 2021 proposed rule for services paid under the Medicare Physician Fee Schedule and the Quality Payment Program that includes the Merit-Based Incentive Payment System (MIPS). In this article, I will provide a summary of the proposed MIPS 2021 program and 2021 Performance Period. MIPS Value Pathways (MVPs) 2021 MIPS Participation Options 2021 Performance Threshold 2021 Performance Category Weights CMS Web Interface Reporting Option Complex Patient Bonus COVID-19 Update in 2020 2021 Quality Measures Proposed Quality Measure Additions to the PT & OT Specialty Set Proposed Quality Measure