In recent months, the Centers for Medicare & Medicaid Services (CMS) and their contractor Acumen have been taking steps forward with development of cost measures for the Merit-Based Incentive Payment System (MIPS). As we previously reported, Acumen conducted field testing on the low back pain measure early this year. AAPM&R submitted comments regarding the field testing and our concerns with the measure in late February. Additionally, Acumen is beginning to consider options for its fifth wave of measure development. It has noted that both interventional pain management and post-acute care are up for consideration during this initial process. AAPM&R submitted comments on the wave 5 announcement early this month. Since CMS and Acumen began the process of developing cost measures, AAPM&R has prioritized having a physiatry presence on workgroups and expert panels. As these processes continue, we will make sure that physiatry has a seat at that table.