Two Weeks Remaining to Submit MIPS Targeted Review Requests

If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website.

This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment being applied to the Medicare paid amount for covered professional services furnished by a MIPS eligible clinician in 2021.

MIPS eligible clinicians, groups, and virtual groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request the Centers for Medicare & Medicaid Services (CMS) to review the calculation of their 2020 MIPS payment adjustment factor(s) through a process called targeted review. The deadline to submit your request is October 5, 2020 at 8:00 p.m. (EDT) – which is only 2 weeks away.

When to Request a Targeted Review

If you believe an error has been made in your MIPS payment adjustment factor(s) calculation, you can request a targeted review until October 5, 2020 at 8:00 p.m. (EDT). Some examples of previous targeted review circumstances include the following:

Errors or data quality issues for the measures and activities you submitted
Eligibility and special status issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)
Being erroneously excluded from the APM participation list and not being scored under the APM Scoring Standard
Performance categories were not automatically reweighted even though you qualify for automatic reweighting due to extreme and uncontrollable circumstances

Note: This is not a comprehensive list of circumstances. CMS encourages you to submit a request form if you believe a targeted review of your MIPS payment adjustment factor (or additional MIPS payment adjustment factor, if applicable) is warranted.

How to Request a Targeted Review

You can access your MIPS final score and performance feedback and request a targeted review by:

Going to the Quality Payment Program website
Logging in using your HCQIS Access Roles and Profile System (HARP) credentials; these are the same credentials that allowed you to submit your MIPS data. Please refer to the QPP Access Guide for additional details.

CMS may require documentation to support a targeted review request that is under our evaluation. If the targeted review request is approved, we may update your 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.

For more information about how to request a targeted review, please refer to the 2019 Targeted Review User Guide.

Questions?

Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, please consider calling during non-peak hours—before 10:00 a.m. and after 2:00 p.m. ET.

Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

QPP Network Security Update: Test Your QPP Website Access Before the End of September

Due to a mandatory security update, you may not be able to access qpp.cms.gov if you have an outdated web browser. Click here to see if your browser will allow you to continue to access QPP after the network update. If the page can’t be displayed, we encourage you to update your web browser to the most current version before the end of September 2020.

Refer to the QPP 2020 Network Security Update Fact Sheet for more details and instructions to test and update your current web browser or contact your IT department for additional assistance.

The Quality Payment Program Developer Preview is Now Open for PY 2020

The Quality Payment Program (QPP) Developer Preview environment is now open for testing QPP submissions for performance year 2020

What is the Developer Preview?

The Developer Preview is a testing environment that allows third party software developers to integrate with various QPP Application Programming Interfaces (APIs) and test their development work prior to the 2020 performance year submissions window.

For more information about Developer Preview, please visit our Developer Tools which has a new section added to provide you further information on the Developer Preview,

https://qpp.cms.gov/developers.

Which QPP APIs are available in the Developer Preview?

The QPP Submissions API and CMS Web Interface API are now available in this testing environment. For more information about these APIs, please visit our Developer Tools,

https://qpp.cms.gov/developers.

Who Can Use the QPP APIs?

The Submissions API is available to approved 2020 Vendors.
- If you are a new Vendor, your Developer Preview token is available for download on the qpp.cms.gov site.
- If you are a returning Vendor your existing Developer Preview token can be used.
- New! Developer Preview tokens can be downloaded from their new location on the Manage Access page. Please see https://cmsgov.github.io/qpp-developer-preview-docs/getting-started for detailed instructions.
The CMS Web Interface API is available to developers supporting APM Entities or the groups and virtual groups who are registered to report through the CMS Web Interface.

Learn More

For more detailed information about updates to the Submissions API and CMS Web Interface API, please refer to the developer preview resources in the Developer Tools section of the QPP website,

For information on QPP access and the Security Official role, please review the Quality Payment Program Access User Guide.

You may also contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292, Monday through Friday, 8:00 a.m.-8:00 p.m. Eastern Time. Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

Having issues accessing?

If you are getting an SSL error when trying to access the Developer Preview Testing environment endpoints, you may be affected by security changes. Please see https://cmsgov.github.io/qpp-developer-preview-docs/announcements for details.