• 2024 MIPS payment adjustments released, targeted reviews available until Oct. 9

    The Centers for Medicare & Medicaid Services (CMS) has released Merit-based Incentive Payment System (MIPS) 2022 performance feedback that impacts next year’s Medicare fee-for-service payments. The 2022 MIPS final score determines whether MIPS-eligible clinicians receive a negative, neutral, or positive payment adjustment in 2024.  

    To view your feedback, including your final score, and 2024 payment adjustment on the Quality Payment Program (QPP) website:

    • Sign in using your Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) system credentials (the same credentials that allowed you to submit your 2022 MIPS data).
    • Click “View Feedback” on the home page.
    • Select your organization (Practice, Alternative Payment Model [APM] Entity, Virtual Group). (Practice representatives can access both individual and group feedback.)

    If you don’t have a HARP account or QPP role, please refer to the "Register for a HARP Account" (re: HARP account) and "Connect to an Organization" (re: QPP role) documents in the QPP Access User Guide (ZIP, 4MB) and start the process now.

    MIPS-eligible clinicians, groups, virtual groups, and APM Entities (along with their designated support staff or authorized third party intermediary) may request targeted reviews until Oct. 9 if they believe there’s an error in the calculation of their MIPS payment adjustment. Examples of previous targeted review circumstances include:

    • Data submitted under the wrong TIN or National Provider Identifier (NPI).
    • Eligibility or special status issues (e.g., you have Qualifying APM Participant status and shouldn’t receive a payment adjustment).
    • Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

    To request a targeted review, sign in using your HARP system credentials* (i.e.,  the same credentials that allowed you to submit your 2022 MIPS data) and click “Targeted Review” on the left-hand navigation.

    CMS generally requires documentation, which varies by circumstance, to support a targeted review request. A CMS representative will contact you about providing this documentation. If the review request results in a scoring change, CMS will update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible. Note that targeted review decisions are final and not eligible for further review.

    For more information about how to request a targeted review, refer to the 2022 Targeted Review User Guide (PDF, 1MB).

    If you have questions about whether your circumstances warrant a targeted review, contact the Quality Payment Program by phone at 1-866-288-8292 (TRS: 711) or by email at QPP@cms.hhs.gov.  

    Individual clinicians and representatives of alternative payment model (APM) Entities can also access performance feedback directly on the QPP website using their HARP account. Performance feedback isn’t related to APM-specific requirements outside of the QPP.

    Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) are encouraged to identify at least one individual within the ACO who can obtain a HARP account with the “Security Official” role; additional individuals may request the “Staff User” role. ACO individuals can create and manage their HARP account and QPP access in the ACO Management System (ACO-MS). Contact your ACO to find out how you can obtain a HARP account via ACO-MS. If you have any questions, contact the ACO Information Center at SharedSavingsProgram@cms.hhs.gov or 1-888-734-6433 (Option 1). Note that representatives of MSSP ACO Participant Taxpayer Identification Numbers (TINs) and practices with clinicians receiving their APM Entity’s final score won’t be able to access the APM Entity’s performance feedback unless they’ve been approved as a staff user for the APM Entity.

    To learn more about the information in your performance feedback, review the following: 

    — Kent Moore, AAFP Senior Manager for Payment Strategies

    Posted on Aug. 21, 2023



    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.