Deadline for Contesting 2022 MIPS Scores and Payment Adjustments Quickly Approaching

The Centers for Medicare & Medicaid Services (CMS) has recently unveiled the Merit-based Incentive Payment Systems (MIPS) performance feedback and final scores for the 2022 performance year. These scores play a crucial role in determining whether a physician will receive a positive, neutral, or negative payment adjustment on Medicare services provided in 2024. The deadline for contesting the 2022 MIPS scores and payment adjustments is October 9, 2023.

Physicians can access their MIPS performance feedback and final scores on the Quality Payment Program (QPP) website using their HCQIS Access Role and Profile (HARP) credentials. These scores are a reflection of a physician’s performance across the four MIPS categories: Quality, Promoting Interoperability, Improvement Activities, and Cost. If a physician believes there was an error in the calculation of their MIPS final score, they have the option to request a targeted review, as referred to by CMS. This process, which allows for an appeal of the final score, must be initiated by October 9, 2023.

Physicians should consider a targeted review if they encounter any of the following circumstances: 1) Data were submitted under the wrong Taxpayer Identification Number or National Provider Number; 2) Eligibility or special status issues, such as a physician having Qualifying APM Participant status and thus not requiring a payment adjustment; 3) Performance categories were not automatically reweighted, despite a physician qualifying for reweighting due to extreme and uncontrollable circumstances.

If a targeted review request is approved and leads to a scoring change, CMS will promptly update the final score and associated payment adjustment, if applicable. It is important to note that targeted review decisions are considered final and are not eligible for further review.

For more information about how to request a targeted review, please refer to the American Medical Association’s 2022 Targeted Review User Guide. Members are encouraged to contact the AANEM policy department with any questions at policy@aanem.org and/or visit our website for more QPP resources