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Quality Payment Program Exceptions

Sponsor
Centers for Medicare and Medicaid Services
Deadlines
Dec 31, 2021
Contact

866.288.8292
QPP@cms.hhs.gov

Purpose

The Centers for Medicare and Medicaid Services provides the opportunity to apply for exceptions to meeting Merit-Based Incentive Payment System (MIPS) program requirements.

In 2021, there are two available exception applications.

(1) Extreme and Uncontrollable Circumstances Exception: An exception based on rare events entirely outside of the facility's control, such as COVID-19.

These circumstances would:

  • Cause the inability to collect information necessary to submit for a MIPS performance category
  • Cause the inability to submit information that would be used to score a MIPS performance category for an extended period of time
  • Impact normal processes, affecting performance on cost measures and other administrative claims measures

(2) Promoting Interoperability Hardship Exception: MIPS eligible clinicians, groups, and virtual groups may request an exception citing one of the following specified reasons:

  • Small practice
  • Have decertified EHR technology
  • Have insufficient internet connectivity
  • Face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress, or vendor issues
  • Lack of control over the availability of CEHRT
Eligibility

MIPS eligible clinicians, groups, and virtual groups that can cite one of the reasons listed above may apply for an exception.

Geographic coverage
Nationwide
Amount of funding

There is no monetary value. This is an exception to participating in the Quality Payment Program.

Application process

Links to additional guidance and the online exception applications by type are available on the program website.

Tagged as
Health information technology · Medicaid · Medicare · Reimbursement and payment models · Technology for health and human services



For complete information about funding programs, including your application status, please contact funders directly. Summaries are provided for your convenience only. RHIhub does not take part in application processes or monitor application status.