September 13, 2024
In case you missed the announcement from the Centers for Medicare & Medicaid Services (CMS), please be aware that CMS released the Final 2023 MIPS Scores/2025 MIPS Payment Adjustments in mid-August. PALTmed urges all physicians and practices to log into the CMS Quality Payment Program (QPP) portal to review their final 2023 MIPS performance year scores. If a physician or practice believes there is an error in the calculation of their MIPS score or accompanying payment adjustment for the 2025 payment year/2023 performance year, please request a targeted review up until Oct. 11, 2024, at 8:00 PM ET through the QPP portal.
Examples of qualifying targeted reviews:
- Data submitted under the wrong TIN or National Provider Identifier (NPI)
- You have Qualifying APM Participant (QP) status and should not receive a MIPS payment adjustment
- Performance categories were not automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances
This is not a comprehensive list of circumstances. If physicians have questions about whether certain circumstances warrant a targeted review, please contact the QPP Service Center by phone at 1-866-288-8292 (TRS: 711) or by email at QPP@cms.hhs.gov.
How to request a targeted review:
Physicians can access their MIPS final score and performance feedback and request a targeted review:
- Sign in using HARP credentials (ACO-MS credentials for Shared Savings Program ACOs); these are the same credentials that allowed submission of 2023 MIPS data.
- Click “Targeted Review” on the left-hand navigation.
CMS generally requires documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact physicians about providing any specific documentation required. If the targeted review request is approved and results in a scoring change, CMS will update the final score and/or associated payment adjustment (if applicable), as soon as technically feasible. Please note that targeted review decisions are final and not eligible for further review.
Targeted review resources:
- 2023 Targeted Review User Guide—Reviews the process for requesting a targeted review and examples for when you would or wouldn’t request a targeted review.
- 2025 MIPS Payment Year Payment Adjustment User Guide—Reviews information about the calculation and application of MIPS payment adjustments, and answers frequently asked questions.