Submit by October 9—2022 MIPS Targeted Review Requests | News

September 25, 2023

If you participated in the Merit-based Incentive Payment System (MIPS) in 2022, you can review your performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website.

For MIPS-eligible clinicians, your 2022 final score determines the payment adjustment you will receive in 2024; a positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished in 2024.

MIPS eligible clinicians, groups, virtual groups, and APM Entities (along with their designated support staff or authorized third-party intermediary) may request that CMS review the calculation of their MIPS payment adjustment factor(s) through a process called targeted review.

When to Request a Targeted Review

If you believe there is an error in the calculation of your MIPS payment adjustment factor(s), you can request a targeted review until October 9, 2023. Some examples of previous targeted review circumstances include the following:

Data were submitted under the wrong Taxpayer Identification Number (TIN) or National Provider Identifier (NPI)
Eligibility or special status issues (e.g., you have Qualifying APM Participant (QP) status and should not receive a payment adjustment).
Performance categories were not automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

Note: This is not a comprehensive list of circumstances. If you have questions about whether your circumstances warrant a targeted review, contact the Quality Payment Program by phone at 1-866-288-8292 (TRS: 711) or by email at QPP@cms.hhs.gov.

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review:

Sign in using your HCQIS Access Roles and Profile (HARP) system credentials*; these are the same credentials that allowed you to submit your 2022 MIPS data.
Click “Targeted Review” on the left-hand navigation.

CMS generally requires documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required. If the targeted review request is approved and results in a scoring change, CMS will update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible. Please note that targeted review decisions are final and not eligible for further review.

For more information about how to request a targeted review, refer to the 2022 Targeted Review User Guide. For more information on payment adjustments, refer to the 2024 MIPS Payment Year Payment Adjustment User Guide.

Members can access 2022 MIPS performance year resources or 2023 MIPS performance year resources online. Contact APMA with any questions or concerns at MIPS@apma.org.