The Centers for Medicare & Medicaid Services (CMS) has released performance feedback and final scores for the 2023 Merit-based Incentive Payment System (MIPS) performance year. This includes information about the MIPS payment adjustments that will take effect in 2025.
Your final score for 2023 will determine whether you receive a positive, negative, or neutral adjustment to Medicare payments for services provided in 2025. Please note that there is no exceptional performance adjustment for the 2023 performance year or the 2025 payment year, as additional funding for this expired after the 2022 performance year.
PY 2023 Change Healthcare Cyberattack Reweighting Requests Will Be Accepted Through 10/11/2024
IMPORTANT: Because CMS is reopening the window for requesting reweighting of one or more MIPS performance categories for PY 2023 in response to the Change Healthcare cyberattack, CMS will only approve applications citing this cyberattack as the basis for requesting reweighting under the MIPS EUC Exception policies. Any applications submitted for reasons outside of the Change Healthcare cyberattack will be denied.
How to Access Your MIPS Feedback
To view your performance feedback and final score:
- Log in to the Quality Payment Program (QPP) website using your Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) credentials. These are the same credentials you used to submit your 2023 MIPS data.
- Click on “View Feedback” from the homepage and select your organization, whether it’s a Practice, Alternative Payment Model (APM) Entity, or Virtual Group.
- Practice representatives can view individual, subgroup, or group feedback. Third-party representatives cannot access final feedback or payment adjustment information.
If you don’t yet have a HARP account or QPP role, refer to the QPP Access User Guide to register and connect to your organization. Start the process as soon as possible to avoid delays.
Request a Targeted Review of Your MIPS Payment Adjustment by October 11, 2024
If you believe there’s been an error in calculating your MIPS payment adjustment, you can request a targeted review. The deadline for submitting your request is October 11, 2024, by 8 p.m. ET.
Here are a few examples of situations that might warrant a review:
- Data was submitted using an incorrect taxpayer identification number (TIN) or national provider identifier (NPI).
- You have Qualifying APM Participant (QP) status and should not be subject to an MIPS payment adjustment.
- Your performance categories were not automatically reweighted, even though you qualified for reweighting due to extreme and uncontrollable circumstances.
Please note that these are just examples, and other situations may also qualify for a targeted review. If you’re unsure whether your case qualifies, contact the QPP Service Center for assistance at 1-866-288-8292 (TRS: 711) or via email at QPP@cms.hhs.gov.
How to Request a MIPS Targeted Review
If you believe there’s an issue with your MIPS final score or payment adjustment, you can request a targeted review by following these steps:
- Log in using your HARP credentials (or ACO-MS credentials for Shared Savings Program ACOs). These are the same credentials you used to submit your 2023 MIPS data.
- Navigate to the left-hand menu and select “Targeted Review.”
When submitting your request, CMS typically requires documentation to support your case. The specific documentation needed may vary depending on the situation, and a CMS representative will contact you if further information is required.
If your targeted review is approved and leads to a scoring change, CMS will update your final score and payment adjustment as soon as possible. Remember that once a targeted review decision is made, it is final and cannot be appealed.
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