2021 Exemption for MIPS Providers Who Can Attest as an Individual

On November 10, 2021, the Centers for Medicare and Medicaid Services (CMS) enacted an exemption for MIPS eligible clinicians who can attest as an individual.

As a result of the COVID-19 public health emergency, CMS will apply an automatic exception for the 2021 performance (PY). This MIPS automatic extreme and uncontrollable circumstances (EUC) policy does not apply to group, virtual groups, or Alternative Payment Model (APM) Entities.

MIPS eligible clinicians reporting as individuals do not need to take any action to have the EUC policy applied for 2021. These individuals will be automatically identified, and all 4 MIPS performance categories reweighted to 0%. These individuals will receive a neutral payment adjustment for the 2023 MIPS payment year unless they:

1) submit data in 2 or more performance categories, or

2) have a higher final score from group or APM entity participation.

Following is a summary of the reweighting policies for individual clinicians. If a provider submits data for two or more categories, the exception will not apply.

Groups, virtual groups and MIPS APM Entities can submit a 2021 EIC Exemption Application citing COVID-19 in their request to reweight one or more MIPS performance categories to 0%.If approved, the requested categories will be reweighted. However, if any data is submitted for the reweighted category, the submitted data will be scored.

To see how Kareo helps practices and their billing companies with MIPS compliance, visit us here.

About the Author

Beth currently serves as an advisor to the Kareo EHR product and engineering teams for clinical enhancements, CMS Incentive program requirements, and other industry/...

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