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Merit-based Incentive
Payment System (MIPS)
2022 Extreme and Uncontrollable
Circumstances Exception Application
Guide

1

Contents

Already know what MIPS is?
Skip ahead by clicking the links in the Table
of Contents.

How to Use This Guide

3

Extreme and Uncontrollable Circumstances Application Overview

5

Extreme and Uncontrollable Circumstances Application Process:
Frequently Asked Questions

13

Extreme and Uncontrollable Circumstances Application Process:
Application Steps

16

Help, Resources, Glossary, and Version History
29
Appendices

33

2

How to Use This Guide

3

How to Use This Guide

Table of Contents
The table of contents is interactive. Click on a
chapter in the table of contents to read that
section.
You can also click on the icon on the
bottom left to go back to the table
of contents.

Please note: This guide was prepared for
informational purposes only and isn’t intended to
grant rights or impose obligations. The information
provided is only intended to be a general summary. It
isn’t intended to take the place of the written law,
including the regulations. We encourage readers to
review the specific statutes, regulations, and other
interpretive materials for a full and accurate statement
of their contents.

Hyperlinks
Hyperlinks to the
Quality Payment Program website are included
throughout the guide to direct the reader to
more information and resources.

Purpose: This guide will provide general information about the Extreme and Uncontrollable Circumstances (EUC)
Exception application and provide step-by-step instructions on how to complete the application.
4

Extreme and
Uncontrollable
Circumstances Application
Overview

5

Extreme and Uncontrollable Circumstances Application
Overview
Overview
We understand that there may be circumstances out of your control that make it difficult for you to meet program
requirements. To reduce this burden, we provide an opportunity for qualifying clinicians, groups, virtual groups and
Alternative Payment Model (APM) Entities to apply for performance category reweighting for MIPS.
The MIPS Extreme and Uncontrollable Circumstances (EUC) Exception application allows you to request reweighting for one
or more performance categories to 0%.
What

Who

Why

When

See Appendix A1, Appendix A2, and Appendix B for more information on performance category reweighting in traditional
MIPS and the APM Performance Pathway (APP).
Individual clinicians, groups, virtual groups, and APM Entities
• Third Party Intermediaries can submit an application with permission from the clinician or practice.
You can submit an application to have your MIPS quality, cost, improvement activities, and/or Promoting Interoperability
performance categories reweighted to 0% if:
• You experience an extreme and uncontrollable circumstance outside of your control, such as a natural disaster,
ransomware attack or public health emergency (PHE) (e.g. COVID-19 pandemic), that prevents you from collecting
data for an extended period of time, or that could impact your performance on cost measures.
Note: APM Entities are required to request reweighting for all performance categories.
Now through January 3, 2023, at 8 p.m. ET.
Sign in to qpp.cms.gov with your HCQIS Access and Roles Profile (HARP) account.

Where

How

You must have a HCQIS Access Roles and Profile (HARP) account to complete and submit an exception application. For more
information on HARP accounts, please refer to the Register for a HARP Account document in the
QPP Access User Guide (ZIP).
Note: APM Entity representatives must have the Security Official role in order to complete the Extreme and Uncontrollable
Circumstances exception application on behalf of their entity. Refer to the Connect to an Organization document in the
QPP Access User Guide (ZIP) for more information on requesting the Security Official role.
1. Register for a HARP account
2. Sign in to qpp.cms.gov
3. Select ‘Exceptions Applications’ on the left-hand navigation
4. Select ‘Add New Exception’
6
5. Select ‘Extreme and Uncontrollable Circumstances Exception’

Extreme and Uncontrollable Circumstances Application
Overview

Policies for Individual Clinicians, Groups, and Virtual Groups
EUC applications can be submitted for one or more
performance categories.
• Any performance category that isn’t included in the
application is eligible for scoring, even if no data are
submitted, unless the clinician or group qualifies for
reweighting under another policy.
Any data you submit, or is submitted on your behalf,
will override reweighting for that performance
category and the category will be scored.
• If you later determine that you’re able to collect
data for a performance category approved in your
application, you can submit that data and it will be
scored.
• If the cost performance category is included in the
application, cost measures won’t be scored even if
data is submitted for other performance categories.
• If you submit Medicare Part B Claims measures
during the performance year, this will override
quality performance category reweighting. However,
if you request and are approved for reweighting in
all 4 performance categories and don’t submit data
for another performance category, your MIPS final
score for the 2022 MIPS performance period would
be equal to the performance threshold and you
would receive a neutral payment adjustment in
2024.

You must be scored on at least 2 performance categories
to earn a MIPS final score other than the performance
threshold.
When fewer than 2 performance categories can be scored
(meaning 1 performance category is weighted at 100% of
your MIPS final score, and the other performance categories
are weighted at 0%), the MIPS final score for the 2022 MIPS
performance period would be equal to the performance
threshold and you would receive a neutral payment
adjustment in 2024.
You will be scored in any performance category that’s not
included in your application, unless you qualify for
reweighting through another policy.

For example:
• If you don’t meet the case minimum for any cost
measures, the cost performance category will be
reweighted.
• You qualify for reweighting under the automatic Extreme
and Controllable Circumstances policy.
o Review the 2022 Automatic Extreme and
Uncontrollable Circumstances Fact Sheet (PDF) for
additional information.
• Certain clinician types and individuals, groups, and virtual
groups with certain special statuses qualify for automatic
reweighting of the Promoting Interoperability
performance category.
o For additional information on automatic
reweighting on Promoting Interoperability, review
the
2022 Promoting Interoperability Quick Start Guide (
PDF
).
7

Extreme and Uncontrollable Circumstances Application
Overview
Intersection Between the Automatic EUC Policy and the Application-Based EUC
Policy
If you qualify for reweighting under the automatic EUC policy, then we’ll reweight all 4 performance categories to 0%
(rather than just the categories included in your EUC application). We’ll score any performance category for which data
is submitted.

Example
Scenario

A MIPS eligible clinician who is eligible for
the automatic EUC policy has also
submitted an EUC exception application.
The application was approved for
reweighting in the Promoting
Interoperability performance category,
and the clinician submits data for the
quality and improvement activities
performance categories.

Outcome
You will be scored as follows:
• The quality and improvement activities performance
categories will be scored because you submitted data for
those categories
• The cost performance category is reweighted to 0% under the
automatic EUC policy.
• The Promoting Interoperability performance category is also
reweighted to 0% under the automatic EUC policy.
Note, in this example, the EUC application wasn’t needed to
reweight the Promoting Interoperability performance category
due to the automatic EUC policy.

8

Extreme and Uncontrollable Circumstances Application
Overview
Individual Clinicians, Groups, and Virtual Groups Reporting Via Traditional MIPS
Example
Scenario

Outcome
You will receive a MIPS final score based on the data submitted.

You’re a MIPS eligible clinician (or group
or virtual group) that is planning to
report via traditional MIPS. You submit
an application to have all 4 performance
categories reweighted, but later
determine you are able to report the
improvement activities and Promoting
Interoperability performance categories.

• The improvement activities performance category will be
weighted at 15%.
• The Promoting Interoperability performance category will be
weighted at 85%.
• The quality performance category will retain a 0% weight
because you didn’t submit quality data.
• The cost performance category will retain a 0% weight
because there are no data submission requirements
associated with the cost performance category (reweighting
can’t be voided).

9

Extreme and Uncontrollable Circumstances Application
Overview
Individual Clinicians and Groups Reporting Via APP
Example
Scenario

You’re a MIPS eligible clinician (or group)
planning to report via the APP. You
submit an application to reweight the
quality performance category and your
application was approved.

Outcome
You will receive a MIPS final score based on the data submitted.
• The improvement activities performance category will be
weighted to 25%.
• The Promoting Interoperability performance category will be
weighted to 75%.
• The quality performance category will be weighted at 0%
provided no data is submitted.
• The cost performance category will retain a 0% weight
(because cost isn’t scored under the APP).

10

Extreme and Uncontrollable Circumstances Application
Overview
APM Entities
APM Entities
APM Entities in the following models can submit an EUC application on behalf of their MIPS eligible
clinicians:
•
•
•
•
•
•
•
•
•
•
•

Medicare Shared Saving Program
Vermont Medicare ACO Model
Bundled Payments for Care Improvement (BPCI) Advanced Model
Oncology Care Model (OCM)
Maryland Total Cost of Care
Independence at Home Demonstration
Primary Care First (PCF)
Value in Opioid Use Disorder Treatment (ViT)
Direct Contracting (DC)
Comprehensive Care for Joint Replacement (CJR) Payment
Kidney Care Choices (KCC)

11

Extreme and Uncontrollable Circumstances Application
Overview
APM Entities (continued)
APM Entity applications must be submitted for all performance categories.
• You can’t submit an application for an APM Entity to request reweighting in 1 or 2 performance categories.
• This is different from our policy for individual, group, and virtual group applications.
If your APM Entity’s application is approved, the APM Entity will receive a final score equal to the performance
threshold even if data are submitted for the APM Entity.
• The MIPS eligible clinicians in the APM Entity will receive a neutral MIPS payment adjustment unless they have a
higher final score from individual or group participation.
• Data submitted for an APM Entity will not override performance category reweighting from an approved
application.
• This is different from our policy for individual, group, and virtual group applications.
At least 75% of MIPS eligible clinicians in an APM Entity must qualify for reweighting of the Promoting
Interoperability performance category.
• Given that APM Entities are required to request reweighting for all performance categories in their EUC
application, at least 75% of the MIPS eligible clinicians in the Entity will need to qualify for reweighting in the
Promoting Interoperability performance category.
• They may qualify automatically or by meeting one of the criteria for the
MIPS Promoting Interoperability Hardship Exception.
APM Entity representatives must have a QPP Security Official role to complete the Extreme and Uncontrollable
Circumstances exception application on behalf of their entity.
• Review the Connect to an Organization resource in the QPP Access User Guide (ZIP) for more information on
obtaining the Security Official role.
An approved application won’t affect your model-specific reporting requirements.
• For example, Shared Savings Program ACOs must report the quality measures identified under the APP to meet
their requirements under the Shared Savings Program, unless otherwise excepted under that APM.
12

Extreme and Uncontrollable
Circumstances Application
Process: Frequently Asked
Questions

13

Extreme and Uncontrollable Circumstances Application
Process: Frequently Asked Questions
How Does CMS Assess EUC Application Requests?

We consider the variables affecting your ability to collect and
submit data for each performance category when reviewing your
application for performance category reweighting due to
extreme and uncontrollable circumstances.
During our review, we will review both the event circumstances
and the length of time you were impacted as indicated in your
application to assess the ability of a MIPS eligible clinician to
submit data for each performance category selected in the
application.

Example:
The performance period for an
improvement activity is a continuous 90-day
period (or as specified in the activity
description) whereas the performance
period for the quality performance category
is 12 months. An issue lasting 3 months
may have more impact on the availability of
measures for the quality performance
category than your ability to perform and
attest to improvement activities.

14

Extreme and Uncontrollable Circumstances Application
Process: Frequently Asked Questions
How Long Does it Take to Process an EUC Exception Application?
• The length of time it takes to process application requests depends on the volume of requests we receive. We review
all application requests in the order that they were received. Once a decision is made regarding your application,
you will receive a notice of our decision and the status of your application will be reflected in your QPP Account on
qpp.cms.gov.

Where Can I Look for a Status Update on My EUC Exception Application?
• You can monitor your application status in your QPP Account on qpp.cms.gov.

Are We Required to Submit Documentation with Our EUC Exception Application?
• No, you aren’t required to submit documentation with your application.
• However, you should retain documentation of the circumstances supporting your application for your own records
in the event that you are selected by CMS for data validation or an audit. See our
2022 MIPS Data Validation Criteria Guide (ZIP) for information on the data validation and audit process.

How Can I Correct a Mistake Made on Our EUC Exception Application?
• If you identified an error with your exception application, please contact the Quality Payment Program at 1-866-2888292, Monday through Friday, 8 a.m.-8 p.m. ET or by e-mail at: [email protected].

Can Additional Staff Members Access/Receive Notifications About the Status of Our EUC Exception Application?
• Yes, you can add additional staff or representatives who should receive notifications about the status of the
application.
• In the Additional Access section of the application, provide the email address(es) of additional staff or
representatives who would like to receive email notifications.
• Please note that the additional staff or representatives must have a HARP credentials in order to see the application
in qpp.cms.gov.

Important Note: Corrections can’t be made after the application period has
closed.
15

Extreme and Uncontrollable
Circumstances Application
Process: Application Steps

16

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 1: Sign in to Your QPP Account
Sign in to your QPP Account at qpp.cms.gov with your
HARP credentials.

Note: If you haven’t signed into qpp.cms.gov before,
you must register for an account to obtain your HARP
credentials.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
17

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 2: Navigate to Your Exception
Applications
Once you are signed into your account select:​
• The Exception Application tab in the left-hand
navigation menu, then click + Add New QPP
Exception​
OR​
• The Start an Application quick link on the home
page.

You can create and submit a new exception
request until 8 p.m. ET on January 3, 2023.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
18

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 3: Select Extreme and
Uncontrollable Circumstances Exception
Select the Extreme and Uncontrollable Circumstances
Exception, then click Continue.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
19

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 4: Select Application Type
Select the participation level at which you intend (or intended) to participate in MIPS.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
20

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 5: Enter Participation Level Information
Enter the required participation level information.
The required information for each participation level is as follows:

Participation
Level

Required Information

• National Provider Identifier
(NPI)
• Practice Affiliation
• Taxpayer Identification
Group
Number (TIN)
Virtual Group • Virtual Group Identifier
• APM Entity ID
APM Entity
Note: If you’re an individual clinician,
group, or virtual group requesting
reweighting of only 1 or 2 MIPS
performance categories and intend to
submit data for others, it is critical that
you select the application type that
aligns with the level at which you
intend to submit data to MIPS (i.e. at
the individual, group or virtual group
level).
Individual
Clinician

*The screenshots included in this user guide were based on the QPP test
environment. Because we are always working to incorporate feedback and
improve experience, there may be differences between these screenshots and
what you see on qpp.cms.gov.

21

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 6: Enter Submitter Details
Enter your contact information (as the submitter) and identify your relationship to the party identified in the
application.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
22

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 7: Enter Additional Staff in the Additional Access Section
You can identify additional users to receive notifications about the application in the Additional Access section.
If there’s a HARP account associated with the email address(es) you provide, the person will be able to sign in to their QPP
Account on qpp.cms.gov and access the application.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
23

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 8: Enter the Extreme and Uncontrollable Circumstances Event Type
Select the appropriate Event Type for the
extreme and uncontrollable circumstance you
experienced.
Then, enter the timeframe for which you were
impacted by the extreme and uncontrollable
event by completing the Event Date Range. If
you continue to be impacted by the event, select
Event Still Persists.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
24

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 9: Provide a Brief Description of the Challenges You Experienced
Provide a brief description about the data collection challenges that you experienced due to the extreme and
uncontrollable event and how your 2022 performance data will be impacted.

Note: You don’t need to submit supporting documentation with your application.
However, you should retain documentation of the circumstances supporting your application for your
own records in the event that you are selected by CMS for data validation or an audit.
See our 2022 MIPS Data Validation Criteria Guide (ZIP) for information on the data validation and audit
process.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
25

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 10: Select MIPS Performance Categories
Select each MIPS performance category for which you are requesting reweighting by checking the corresponding box
next to the category name, then select Submit for Review.

Note: All performance
categories will be automatically
selected for APM Entity
applications.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
26

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Step 11: Submit Extreme and Uncontrollable Circumstances Application
Once you are done with your application, review the disclosures, then select the Submit for Review button.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on

27

Extreme and Uncontrollable Circumstances Application
Process: Application Steps
Extreme and Uncontrollable Circumstances Exception Application Submission
Confirmation
After you submit your application, you will receive a message stating that your application has been successfully submitted
and is pending review. You will also receive an email notification.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve experience, there may be differences between these screenshots and what you see on
qpp.cms.gov.
28

Help, Resources, and Version
History

29

Help, Resources, and Version History
Where Can You Go for Help?

Contact the Quality Payment
Program at 1-866-288-8292,
Monday through Friday, 8 a.m.-8
p.m. ET or by e-mail at:
[email protected].
• Customers who are hearing
impaired can dial 711 to be
connected to a TRS
Communications Assistant.

Visit the Quality Payment Program
website for other
help and support information, to
learn more about MIPS, and to
check out the resources available
in the QPP Resource Library.

30

Help, Resources, and Version History
Additional Resources
The Quality Payment Program Resource Library houses fact sheets, measure specifications, specialty guides, technical
guides, user guides, helpful videos, and more. We will update this table as more resources become available.

Resource
2022 Automatic Extreme and Uncontrollable Circumstances Policy Fact Sheet (P
DF)
2022 MIPS Promoting Interoperability Hardship Exception Application Guide (P
DF)

31

Help, Resources, and Version History
Version History
If we need to update this document, changes will be identified here.

Date

Description

10/06/2022

Updated deadline to request an exception to January 3,
2023, at 8 p.m. ET (slides 6 and 18)

05/02/2022

Original Posting.

32

Appendices

33

Appendices
Appendix A1: 2022 Performance Year MIPS Performance Category Weight Redistribution
Policies for Individual Clinicians, Groups, Virtual Groups, and APM Entities Reporting
Traditional MIPS
The table below illustrates the 2022 performance category weights
and reweighting policies that CMS will apply to clinicians, groups,
and virtual groups reporting traditional MIPS. (Small practices
should refer to Appendix A2.)

Refer to Appendix B for reweighting
policies for APM Entities reporting the
APP. APM Entities reporting traditional
MIPS can only request reweighting for
all performance categories.

If fewer than 2 performance categories can be scored (meaning 1 performance category is weighted at 100%, or all
performance categories are weighted at 0%), the clinician, group, or virtual group will receive a final score equal to the
performance threshold and the MIPS eligible clinicians will receive a neutral payment adjustment in the 2024 payment year.
Cost Category
Weight

Improvement
Activities
Category
Weight

Promoting
Interoperability
Category Weight

30%

30%

15%

25%

Reweight 1 Performance Category
No Cost
(Cost  Quality and Promoting Interoperability)

55%

0%

15%

30%

No Improvement Activities
(Improvement Activities  Quality)

45%

30%

0%

25%

No Promoting Interoperability
(Promoting Interoperability  Quality)

55%

30%

15%

0%

No Quality
(Quality  Promoting Interoperability)

0%

30%

15%

55%

Quality
Category
Weight

No Reweighting
Standard Weighting under traditional MIPS

MIPS Performance Category Reweighting
Scenario

Table continues on the following
slide.

34

Appendices
Appendix A1: 2022 Performance Year MIPS Performance Category Weight Redistribution
Policies for Individual Clinicians, Groups, Virtual Groups, and APM Entities Reporting
Traditional MIPS (continued)
Quality
Category
Weight

Cost
Category
Weight

Improvement
Activities
Category
Weight

Promoting
Interoperability
Category Weight

Reweight 2 Performance Categories
No Cost + No Promoting Interoperability
(Cost + Promoting Interoperability  Quality)

85%

0%

15%

0%

No Cost + No Quality
(Cost + Quality  Promoting Interoperability)

0%

0%

15%

85%

No Cost + No Improvement Activities
(Cost + Improvement Activities  Promoting Interoperability +
Quality)

70%

0%

0%

30%

No Promoting Interoperability + No Quality
(Promoting Interoperability + Quality  Cost + Improvement
Activities)

0%

50%

50%

0%

MIPS Performance Category Reweighting Scenario

No Promoting Interoperability + No Improvement
Activities
Reweight
Performance Categories
70%
30%
0%
0%
(Promoting3Interoperability
+ Improvement Activities 
If
you have multiple performance categories reweighted to 0% so that a single performance category is weighted at 100% of your final
Quality)
score, you will receive a score equal to the performance threshold regardless of any data submitted or not and receive a neutral payment
No Quality + No Improvement Activities
adjustment.
(Quality + Improvement Activities  Promoting
0%
30%
0%
70%
Reweight 4 Performance Categories
Interoperability)
If all performance categories are reweighted to 0%, you will receive a score equal to the performance threshold regardless of any data
submitted or not and receive a neutral payment adjustment.
35

Appendices
Appendix A2. MIPS Performance Category Weight Redistribution Policies Under
Traditional MIPS Finalized for the 2022 Performance Year: Small Practices
The table below illustrates the 2022 performance
category weights and reweighting policies that CMS will
apply to small practices.

MIPS Performance Category
Reweighting Scenario
No Reweighting
Standard Weighting under traditional
MIPS for small practices

Refer to Appendix B for reweighting policies that
apply to APM Entities reporting the APP. APM
Entities reporting traditional MIPS can only request
reweighting for all performance categories.

Quality
Category Weight

Cost Category
Weight

Improvement
Activities
Category
Weight

30%

30%

15%

25%

Promoting
Interoperability
Category Weight

Reweight 1 Performance Category
No Cost
(Cost  Quality and Promoting
Interoperability)
No Improvement Activities
(Improvement Activities  Quality)
No Promoting Interoperability
(Promoting Interoperability  Quality and
Improvement Activities)
No Quality
(Quality  Promoting Interoperability)

55%

0%

15%

30%

45%

30%

0%

25%

40%

30%

30%

0%

0%

30%

*Table
continues on next 55%
slide.
15%
36

Appendices
Appendix A2. MIPS Performance Category Weight Redistribution Policies Under
Traditional MIPS Finalized for the 2022 Performance Year: Small Practices (continued)
MIPS Performance Category
Reweighting Scenario
Reweight 2 Performance Categories
No Cost + No Promoting Interoperability
(Cost + Promoting Interoperability 
Quality and Improvement Activities)
No Cost + No Quality
(Cost + Quality  Promoting
Interoperability)
No Cost + No Improvement Activities
(Cost + Improvement Activities 
Promoting Interoperability + Quality)
No Promoting Interoperability + No
Quality
(Promoting Interoperability + Quality 
Cost + Improvement Activities)

Quality
Category Weight

Cost Category
Weight

Improvement
Activities
Category
Weight

50%

0%

50%

0%

0%

0%

15%

85%

70%

0%

0%

30%

0%

50%

50%

0%

Promoting
Interoperability
Category Weight

No Promoting Interoperability + No
Improvement Activities
70%
30%
0%
0%
(Promoting Interoperability +
Improvement
Activities
 Quality)
Note: If you have
multiple
performance categories reweighted to 0% so that a single performance category is weighted at
100%
of your
finalImprovement
score, you willActivities
receive a score equal to the performance threshold regardless of any data submitted or
No
Quality
+ No
not submitted. See next slide for additional information.
(Quality + Improvement Activities 
0%
30%
0%
70%
Promoting Interoperability)

37

Appendices
Appendix B. 2022 Performance Year MIPS Performance Category Weight Redistribution
Policies for APM Entities and APM Participants Reporting the APP
The table below illustrates the 2022 performance category weights and reweighting
policies that CMS will apply to APM Entities reporting traditional MIPS and to individual
clinicians, groups and APM Entities reporting via the APP.
Reminders:

• Cost isn’t scored under the APP.

Reminder: APM Entities can
only submit an EUC
Application for all
performance categories.

• There are no reporting requirements for the improvement activities performance category under the APP for

performance year 2022. Participants reporting via the APP will automatically receive full credit for the improvement
activities performance category.

• Participants reporting via the APP will follow the same reporting requirements as traditional MIPS for the Promoting
Interoperability performance category.

Quality
Category Weight

Cost Category
Weight

Improvement
Activities
Category
Weight

Promoting
Interoperability
Category Weight

Standard Weighting under the APP

50%

0%

20%

30%

Reweight 1 Performance Category
No Promoting Interoperability
(Promoting Interoperability  Quality)

75%

0%

25%

0%

0%

0%

25%

75%

MIPS Performance Category
Reweighting Scenario
No Reweighting

No Quality
(Quality  Promoting Interoperability)
Reweight 2+ Performance Categories

If you have multiple performance categories reweighted to 0% so that a single performance category is weighted at 100%
of your final score, you will receive a score equal to the performance threshold regardless of any data submitted or not and
receive a neutral payment adjustment.

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Appendices
Appendix C. MIPS Promoting Interoperability Hardship Exception Application Status
Descriptions
The table below provides a description of each application status in the order of which they occur.

Draft in Progress

Submitted – Pending
Approval

You are currently working
on your application and
haven’t submitted it yet.

You have successfully
completed and submitted
your application.

Select Manage to continue
working on your
application.

Applications are reviewed in
the order of which they are
received.

Approved / Denied

We completed our review of
your application and
approved your request.

We completed our review of
your application and denied
your request.

Withdrawn

You have withdrawn your
application. You can
withdraw your application
at any point in the process.
An application can’t be
reopened after being
withdrawn. You’ll need to
complete a new application.

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