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Last week, CMS announced the following updates to the Merit-Based Incentive Payment System (MIPS):
Applications are now open for the MIPS Promoting Interoperability Performance Category Hardship Exception and Extreme and Uncontrollable Circumstances Exception for the 2021 Performance Year. The deadline to submit your applications to CMS is December 31, 2021.
PI Hardship Exception Eligibility: MIPS eligible clinicians, groups, and virtual groups may submit a MIPS Promoting Interoperability Performance Category Hardship Exception Application whether they are reporting traditional MIPS or the APM Performance Pathway. Exceptions are granted if they:
NOTE: If you are already exempt from submitting Promoting Interoperability data, you do not need to apply.
MIPS eligible clinicians, groups, and virtual groups may submit an application to reweight any or all MIPS performance categories if they’ve been affected by extreme and uncontrollable circumstances extending beyond the Promoting Interoperability performance category. These circumstances must:
For 2021 MIPS PY information and updates, visit www.apma.org/MIPS2021.
Recognizing the ongoing COVID-19 PHE impact on clinicians, CMS is reweighting the cost performance category from 15 percent to 0 percent for the 2020 performance period. The 15-percent cost performance category weight will be redistributed to other performance categories in accordance with § 414.1380(c)(2)(ii)(D). See the table below for reweighting scenarios.
CMS examined the underlying data for 2020 and found that in comparison to prior years’ data, the volume of data available to calculate the scores for the cost measures had significantly decreased overall. As a result, CMS did not believe it could reliably calculate scores for the cost measures that would adequately capture and reflect the performance of MIPS eligible clinicians, for the following reasons:
Clinicians do not need to take any action as a result of this decision because the cost performance category relies on administrative claims data.
MIPS Performance Category Reweighting Scenario |
Quality Category Weight |
Cost Category Weight |
Improvement Activities Category Weight |
Promoting Interoperability Category Weight |
No Additional Reweighting Applies |
55% |
0% |
15% |
30% |
Reweight 2 Performance Categories |
||||
No Promoting Interoperability, No Cost |
85% |
0% |
15% |
0% |
No Quality, No Cost |
0% |
0% |
15% |
85% |
No Improvement Activities, No Cost |
70% |
0% |
0% |
30% |
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Learn MoreMIPS Updates—2023 PY Hardship Application Now Available, Webinars, and Updated Resources
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