PowerPoint Presentation

Status: The document is viewable through fallback artifacts while conversion repair continues in the background.

Queue: A repair attempt failed. The document remains flagged for retry and verification. (priority 90 · attempts 64 · next 2026-08-26 21:43:40)

Missing: html

Download: Source copy (pptx) | pdf

Merit-based Incentive
Payment System (MIPS)
2023 MIPS Promoting
Interoperability Performance
Category Hardship Exception
Application Guide

Table of Contents

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

How to Use This Guide

3

MIPS Promoting Interoperability Performance Category Hardship Exception Application Overview
5
MIPS Promoting Interoperability Performance Category Hardship Exception Information
7
MIPS Promoting Interoperability Performance Category Hardship Exception: Frequently Asked Questions
12
MIPS Promoting Interoperability Performance Category Hardship Exception: Application Steps
14
Help and Version History
30
Appendices

33

Purpose: This guide will provide general information about the MIPS Promoting Interoperability Performance
Category Hardship Exception application and provide step-by-step instructions on how to complete the application.

2

How to Use this Guide

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.

4

MIPS Promoting
Interoperability Performance
Category Hardship Exception
Application Overview

MIPS Promoting Interoperability Performance Category
Hardship Exception Application Overview
Overview
What

Who

Why

When
Where

How

MIPS Promoting Interoperability Hardship Exception applications allow you to request that your MIPS Promoting
Interoperability performance category be reweighted to 0%.
Individual clinicians, groups, and virtual groups reporting via traditional MIPS, MIPS Value Pathways (MVPs) or the APM
Performance Pathway (APP).
• Third party intermediaries can submit an application with permission from the clinician or practice.
Some clinicians, groups and virtual groups automatically qualify for reweighting of the Promoting Interoperability
performance category. If you qualify for automatic reweighting, you don’t need to apply for a MIPS Promoting
Interoperability Hardship Exception.
• See Appendix A for information about the clinicians, groups, and virtual groups that automatically qualify for
reweighting of this performance category.
You can submit an application to have your MIPS Promoting Interoperability performance category reweighted to 0% if:
Note: We automatically reweigh
Promoting Interoperability for small
• You have insufficient Internet connectivity
practices. See page 8 for more
• You have decertified electronic health record (EHR) technology
information.
• You lack control over the availability of certified EHR technology (CEHRT)
o Lacking 2015 Edition CEHRT doesn’t qualify as a reason to submit an exception application
• You face extreme and uncontrollable circumstances such as a disaster, practice closure, severe financial distress or
vendor issues
o If you experience an extreme and uncontrollable circumstance that impacts multiple performance
categories, the Extreme and Uncontrollable Circumstances Exception application may be more suitable for
your given circumstance.
The Promoting Interoperability Hardship Exception application will close at 8 p.m. ET on January 2, 2024.
Sign in to qpp.cms.gov with your HCQIS Access and Roles Profile (HARP) account.
• For more information on HARP accounts, please refer to the Register for a HARP Account document in the
QPP Access User Guide (ZIP).
1. Register for a HARP account
2. Sign in to the QPP website
3. Select ‘Exceptions Application’ on the left-hand navigation
4. Select ‘Add New Exception’
5. See
Select
‘Promoting
Interoperability
Hardship
Exception’
Appendix
B (traditional
MIPS) and
Appendix
C (APP) for more information on performance category
6. Complete the application for individual, group
or virtual group participation
reweighting.

6

MIPS Promoting
Interoperability Performance
Category Hardship Exception
Information

MIPS Promoting Interoperability Performance Category
Hardship Exception Information
Overview
You may automatically qualify for reweighting in this performance category.

Reminder: Small practices qualify
for automatic reweighting.

• See Appendix A.
• If you automatically quality for reweighting, you don’t need to submit an exception application.
You’ll complete the Hardship Exception application at the level for which you’ll report data to MIPS.

• If you’re reporting data at the individual level, complete the Hardship Exception application at the individual level.
• If you’re reporting data at the group level, complete the Hardship Exception application at the group level.
• Note, a group Hardship Exception application will only apply at the group level.
o If your practice is participating in MIPS at the individual level, don’t complete the Hardship Exception
application at the group level. You’ll complete the Hardship Exception application at the individual level for
each clinician (who doesn’t automatically qualify for reweighting) to be considered for reweighting.

o If you’re reporting as an MVP as a subgroup, the group level Hardship Exception will apply to the subgroup
participants.
You can still submit data for the MIPS Promoting Interoperability performance category.

• If your circumstances change and you’re able to collect and submit your Promoting Interoperability data, we’ll
disregard your Hardship Exception application and you’ll be scored in this performance category.
• You’ll also be scored in this performance category if you attest to any data, such as selecting performance period
dates or responding to attestation statements, during the submission period.
• Small practices qualify for automatic reweighting of the Promoting Interoperability performance category.

8

MIPS Promoting Interoperability Performance Category
Hardship Exception Information
Overview (Continued)
You aren’t required to submit documentation with your application.

• However, clinicians, groups, and virtual groups should retain documentation of their circumstances supporting
their application for their own records in the event they’re selected by CMS for data validation or audit. See our
2023 MIPS Data Validation Criteria (ZIP) for details on the data validation process.
You can apply for a MIPS Promoting Interoperability performance category hardship exception if you switch
CEHRT vendors during the performance period.

• You would indicate an extreme and uncontrollable circumstances hardship exception and select vendor issues
within the application.
The following circumstances qualify as extreme and uncontrollable circumstances for a MIPS Promoting
Interoperability performance category hardship exception:

• A natural disaster resulting in damage to or destruction of your CEHRT
• Practice closure
• Severe financial distress resulting in bankruptcy or debt restructuring
• Vendor issues (such as a change in vendors during the performance period or errors with your CEHRT that your
vendor is unable to address)
You may still be able to report if your EHR product is decertified during the 2023 performance year.

• You can still submit your Promoting Interoperability performance category measures collected in your nowdecertified EHR product if your performance period ended before the decertification occurred.
• If your performance period ended after the EHR decertification occurred, you can apply for a MIPS Promoting
Interoperability performance category hardship exception and select decertified EHR technology.

9

MIPS Promoting Interoperability Performance Category
Hardship Exception Information
Groups and Virtual Groups
To submit an application on behalf of a group, every office location/practice site within the taxpayer
identification number (TIN) must experience the hardship for the group to qualify for the Promoting
Interoperability performance category hardship exception.
• For example, if one office location is within a broadband availability area but the other office(s) for the
practice is not, the office with broadband availability would not qualify for the MIPS Promoting
Interoperability performance category hardship and must report for those clinicians for whom they
have data.
To submit an application on behalf of a virtual group, every office location/practice site for each TIN
within the virtual group must experience the hardship for the virtual group to qualify for the Promoting
Interoperability performance category hardship exception.
• For example, if one TIN is within a broadband availability area but the other TIN(s) in the virtual group is
not, the TIN with broadband availability would not qualify for the MIPS Promoting Interoperability
performance category hardship and must report for those clinicians for whom they have data.

10

MIPS Promoting Interoperability Performance Category
Hardship Exception Information
MIPS APM Participants
MIPS eligible clinicians and groups with MIPS eligible clinicians participating in a MIPS APM can apply
for hardship exceptions and qualify for automatic reweighting just like other MIPS eligible clinicians.
If you’re participating in MIPS at the APM Entity level (either reporting traditional MIPS or the APP), you
would complete the application as an individual or group.
• If approved, the clinician will receive the APM Entity’s score, but will be excluded from the calculation
when we create an average Promoting Interoperability score for the APM Entity.
APM Entities reporting the APP or traditional MIPS can’t submit a Promoting Interoperability Hardship
Exception application on behalf of the entire Entity.
• When participating in MIPS as an APM Entity, the Promoting Interoperability performance category is
still reported at the individual or group level.
A MIPS Promoting Interoperability performance category hardship exception doesn’t exempt you from
reporting on any CEHRT activities required for participation in your APM.

11

MIPS Promoting
Interoperability Performance
Category Hardship Exception:
Frequently Asked Questions

MIPS Promoting Interoperability Performance Category
Hardship Exception: Frequently Asked Questions

Question
Where Can I Look for a Status Update
on Our MIPS Promoting
Interoperability Performance
Category Hardship Exception
Application?

Answer
You can monitor your application status in your QPP Account on the
QPP website.
Yes, you can add additional staff or representatives who should receive
notifications about the status of the application.

Can Additional Staff Members
Access/Receive Notifications About
the Status of the MIPS Promoting
Interoperability Performance
Category Hardship Exception
Application?

How Can I Correct a Mistake Made on
Our MIPS Promoting Interoperability
Performance Category Hardship
Exception 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: the additional staff or representatives must have HARP
credentials in order to see the application on the QPP website.
If you identified an error with your exception application, please contact
the Quality Payment Program Service Center by email at
[email protected], create a QPP Service Center ticket, or by phone at 1866-288-8292 (Monday-Friday, 8 a.m. - 8 p.m. ET).

13

MIPS Promoting
Interoperability Performance
Category Hardship Exception:
Application Steps

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 1: Sign in to Your QPP Account
With your HARP credentials, sign in to your QPP Account on the
QPP website.
Note: If you haven’t signed in on the QPP website
before, you must register for an account to obtain
your HARP credentials. See our
QPP Account Access Guide (ZIP) for information on
creating an account.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve the experience, there may be differences between these screenshots and what you see on
the QPP website.
15

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 2: Navigate to Your Exception Applications
Once you’re signed into your account, select:
OR

• The Exception Application tab in the left-hand navigation menu, then click + Add New QPP Exception
• 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 2, 2024.

*The screenshots included in this user guide were
based on the QPP test environment. Because we
are always working to incorporate feedback and
improve the experience, there may be differences
between these screenshots and what you see on
the QPP website.
16

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 3: Select the Exception Application
Select the MIPS Promoting Interoperability Performance
Category Hardship Exception, then 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 the experience, there may be differences
between these screenshots and what you see on the QPP website.
17

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 4: Select Application Type
Select the participation level at which you intend to participate in MIPS, then select Save & Continue.

(Image features application at the individual level)

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

MIPS Promoting Interoperability Performance Category
Hardship Exception: 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
Individual
Clinician
Group
Virtual Group

Required Information
• National Provider Identifier
(NPI)
• Practice Affiliation
• Taxpayer Identification
Number (TIN)
• Virtual Group Identifier

(Image features application at the individual level)
*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve the experience, there may be differences between these screenshots and what you see on
the QPP website.
19

MIPS Promoting Interoperability Performance Category
Hardship Exception: 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 the experience, there may be differences between these screenshots and what you see on
the QPP website.
20

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 7: Enter Additional Staff in 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
into their own account on the QPP website 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 the experience, there may be differences between these screenshots and what you see on
the QPP website.
21

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 8: Select the Reason for the MIPS Promoting Interoperability Hardship
Select the option that aligns with your reason for submitting an MIPS Promoting Interoperability Hardship
Exception application.

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 case you are selected
by CMS for data validation or an
audit. See our
2023 MIPS Data Validation Criteri
a
for details on the data validation
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 the experience, there may be differences between these screenshots and what you see on
the QPP website.
22

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 9: Complete Attestation and Provide Event Description
Before submitting your application, you must complete the attestation (differs for each reason option).
• Insufficient Internet Connectivity
• Extreme and Uncontrollable Circumstances
• Lack of Control Over the Availability of CEHRT
• EHR Decertification
You also can provide an optional brief description on the hardship you experienced and how performance
data is impacted.

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

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 9: Complete Attestation and Provide Event Description (Continued)
Reason Option 1: Insufficient Internet Connectivity
Review the attestation statement and select “I attest.”
You can provide an optional description of the hardship event.

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

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 9: Complete Attestation and Provide Event Description (Continued)
Reason Option 2: Extreme and Uncontrollable
Circumstances
Select the extreme and uncontrollable circumstances
event type that applies to you, enter the event dates,
then review the attestation statement and select “I
attest.”
You can provide an optional description of the
hardship event.

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

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 9: Complete Attestation and Provide Event Description (Continued)
Reason Option 3: Lack of Control Over the
Availability of CEHRT
Review the attestation statement and select “I
attest.” You can provide an optional description of
the hardship event.

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

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 9: Complete Attestation and Provide Event Description (Continued)
Reason Option 4: EHR Decertification
Enter the date that your EHR was decertified and
your ONC-ACB Certification ID. Then, review the
attestation statement and select “I attest.”
You can provide an optional description of the
hardship event.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve the experience, there may be differences between these screenshots and what you see on
the QPP website.
27

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
Step 10: Submit MIPS Promoting Interoperability Hardship Application
Once you’re done with your application, review the disclosures, then select Certify & Submit.

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

MIPS Promoting Interoperability Performance Category
Hardship Exception: Application Steps
MIPS Promoting Interoperability Hardship Application Submission
Confirmation

After you submit your MIPS Promoting Interoperability Hardship application, you will receive a message
stating that your hardship application has been successfully submitted and is pending review.
You’ll also receive an email notification.

See Appendix D for information
on the various application
statuses.

*The screenshots included in this user guide were based on the QPP test environment. Because we are always working to
incorporate feedback and improve the experience, there may be differences between these screenshots and what you see on
the QPP website.
29

Help and Version History

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

Contact the Quality Payment
Program Service Center by
email at [email protected],
create a
QPP Service Center ticket, or by
phone at 1-866-288-8292
(Monday through Friday,
8 a.m. - 8 p.m. ET).
• People who are deaf or hard
of hearing can dial 711 to be
connected to a TRS
Communications Assistant.

Visit the
Quality Payment Program webs
ite
for other
help and support information,
to learn more about MIPS, and
to check out the resources
available in the
Quality Payment Program Reso
urce Library
.

31

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

Date

Description

09/29/2023

Updated Appendix A to add clinical social workers as
individual clinicians eligible for reweighting and
Appendix D to adjust the reporting entities for
whom the table is applicable.

05/01/2023

Original Posting.

32

Appendices

Appendices

Appendix A.
Automatic Reweighting in the MIPS Promoting Interoperability Performance
Category
Reason for Reweighting (Individual Clinicians)

You have one of these Special Statuses:
• Small Practice;
• Ambulatory Surgical Center (ASC)-based;
• Hospital-based; or
• Non-patient facing
You are one of these clinician types:
• Physical therapist
• Occupational therapist
• Qualified speech-language pathologist
• Qualified audiologist
• Clinical psychologist
• Registered dietitian or nutrition professional
• Clinical social worker

Action Needed by the Individual

None – You’re automatically excepted from having to submit
data for this performance category as an individual, though you
may still choose to do so.
You’ll be scored in this performance category if your practice is
participating as a group or virtual group and doesn’t qualify for
reweighting.
None – You’re automatically excepted from having to submit
data for this performance category as an individual, though you
may still choose to do so.
You’ll be scored in this performance category if your practice is
participating as a group or virtual group and doesn’t qualify for
reweighting.

Reason for Reweighting (Groups and Virtual Groups)

Action Needed by the Group or Virtual Group

You have one of these Special Statuses:
• Ambulatory Surgical Center (ASC)-based.
• Small Practice
• Hospital-based: Group or virtual group must have more

You’ll be scored in this performance category if your practice is
participating as a group or virtual group and doesn’t qualify for
reweighting.

than 75% of clinicians designated as hospital-based.

• Non-patient facing: Group or virtual group must have
more than 75% of clinicians designated as non-patient
facing.
All of the MIPS eligible clinicians in your group or virtual
group qualify for reweighting as individuals (through any

You’ll be scored in this performance category if your practice is
34for
participating as a group or virtual group and doesn’t qualify

Appendices

Appendix B.
MIPS Performance Category Weight Redistribution Policies Under Traditional
MIPS Finalized for the 2023 Performance Year: Individual Clinicians, Groups
and Virtual Groups
The table below illustrates the 2023 performance category weights and reweighting policies that CMS will apply to
clinicians, groups, and virtual groups reporting via traditional MIPS.
Refer to Appendix D for
reweighting policies that
apply to APM Entities.

Important Reminders:
o Individual Clinicians, Groups, Virtual Groups: 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 2025 payment year.
Quality Category
Weight

Cost Category
Weight

Improvement
Activities
Category Weight

Promoting
Interoperability
Category Weight

30%

30%

15%

25%

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%

MIPS Performance Category Reweighting
Scenario
No Reweighting
Standard Weighting under traditional
MIPS
Reweight 1 Performance Category
No Cost
(Cost  Quality and Promoting
Interoperability)

*Table
15% continues on next
55%
slide.

Note:
Small
practices
have a
different
distributio
n policy
than
individual
clinicians,
larger
groups,
and virtual
groups.
35

Appendices

Appendix B.
MIPS Performance Category Weight Redistribution Policies Under Traditional
MIPS Finalized for the 2023 Performance Year: Individual Clinicians, Groups
and Virtual Groups (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%

70%

0%

0%

30%

0%

50%

50%

0%

70%

30%

0%

0%

MIPS Performance Category Reweighting
Scenario

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

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

*Table continues on next
slide.

36

Appendices
Appendix B.
MIPS Performance Category Weight Redistribution Policies Under Traditional
MIPS Finalized for the 2023 Performance Year: Individual Clinicians, Groups
and Virtual Groups (Continued)
MIPS Performance Category
Reweighting Scenario

Quality
Category Weight

Cost Category
Weight

Improvement
Activities
Category
Weight

Promoting
Interoperability
Category Weight

Reweight 3 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’ll receive a score equal to the performance threshold regardless of any data submitted or not and
receive a neutral payment adjustment.
Reweight 4 Performance Categories
If all performance categories are reweighted to 0%, you’ll receive a score equal to the performance threshold regardless of
any data submitted or not and receive a neutral payment adjustment.

37

Appendices
Appendix C.
MIPS Performance Category Weight Redistribution Policies Under Traditional
MIPS Finalized for the 2023 Performance Year: Small Practices
The table below illustrates the 2023 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 D for reweighting policies that
apply to APM Entities reporting the APP. APM
Entities reporting traditional MIPS or MVPs
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%

15%

55%

*Table continues on next slide.

38

Appendices

Appendix C.
MIPS Performance Category Weight Redistribution Policies Under Traditional
MIPS Finalized for the 2023 Performance Year: Small Practices
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)
No Promoting Interoperability + No
Improvement Activities
(Promoting Interoperability + Improvement
Activities  Quality)

Quality Category
Weight

Cost Category
Weight

Improvement
Activities
Category Weight

Promoting
Interoperability
Category Weight

50%

0%

50%

0%

0%

0%

15%

85%

70%

0%

0%

30%

0%

50%

50%

0%

70%

30%

0%

0%

No
Quality
+ have
No Improvement
Activities categories reweighted to 0% so that a single performance category is weighted at
Note:
If you
multiple performance
(Quality
Improvement
Activities

100% of+your
final score,
you’ll receive
a score equal to the performance threshold regardless of any data submitted or not
0%
30%
0%
70%
submitted.Interoperability)
See next slide for additional information.
Promoting
39

Appendices
Appendix D.
MIPS Performance Category Weight Redistribution Policies for APM Entities
and the APP Finalized for the 2023 Performance Year
The table below illustrates the 2023 performance category weights and reweighting policies that apply to
individual clinicians, groups and APM Entities reporting the APP.
Reminders:
• Cost is not scored under the APP.
• There are no reporting requirements for the improvement activities performance category under the
APP for the 2023 performance year. Participants reporting via the APP will automatically receive full
credit for the improvement activities performance category for the 2023 performance year.
• Participants reporting via the APP will follow the same reporting requirements as traditional MIPS for
the Promoting Interoperability performance category.
MIPS Performance Category Reweighting
Scenario under the APP

Quality Category
Weight

Cost Category
Weight

Improvement
Activities
Category Weight

Promoting
Interoperability
Category Weight

50%

0%

20%

30%

75%

0%

25%

0%

0%

0%

25%

75%

No Reweighting
Standard Weighting under the APP
Reweight 1 Performance Category
No Promoting Interoperability
(Promoting Interoperability  Quality)
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’ll receive a score equal to the performance threshold regardless of any data submitted or not and receive a neutral
40
payment adjustment.

Appendices
Appendix E.
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’re currently working
on your application and
haven’t submitted it yet.

You’ve successfully
completed and submitted
your application.

Select Manage to
continue working on your
application.

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

Approved / Denied

Withdrawn

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

You’ve withdrawn your
application. You can
withdraw your application
at any point in the
process.

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

An application can’t be
reopened after being
withdrawn. You’ll need to
complete a new
application.

41