MIPS Extreme and Uncontrollable Circumstances Exception Application
How to Apply
Additional Resources
2025 QPP Exception Applications are Now Available
The 2025 Quality Payment Program (QPP) Exception applications are available now through December 31, 2025, at 8 p.m. ET. There are 2 types of exception applications that allow users to indicate the reason they’re unable to report data for one or more Merit-based Incentive Payment System (MIPS) performance categories.
Individual clinicians, groups, and virtual groups (or a third-party representative) can submit a MIPS Promoting Interoperability Performance Category Hardship Exception application for the following reasons:
You have decertified Electronic Health Record (EHR) technology (must be decertified under the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) Health IT Certification Program).
You have insufficient internet connectivity.
You face extreme and uncontrollable circumstances such as a disaster, practice closure, severe financial distress, or vendor issues.
You lack control over the availability of certified EHR technology (CEHRT).
This application is specific to the MIPS Promoting Interoperability performance category. If your application is approved, you won’t be required to report data for this performance category.
MIPS Extreme and Uncontrollable Circumstances Exception Application
Individual clinicians, groups, and virtual groups (or a third-party representative) can submit a MIPS Extreme and Uncontrollable Circumstances (EUC) Exception application for one or more MIPS performance categories (quality, cost, improvement activities, and Promoting Interoperability) due to extreme and uncontrollable circumstances, defined as rare events entirely outside of your control and the control of the facility in which you practice.
These circumstances would:
Cause you to be unable to collect information necessary to submit for a MIPS performance category.
Cause you to be unable to submit information that would be used to score a MIPS performance category for an extended period of time (for example, if you were unable to collect data for the quality performance category for 3 months).
Impact your normal processes, affecting your performance on cost measures and other administrative claims measures.
Alternate Payment Model (APM) Entities can submit applications as well, but they must apply for all performance categories.
If your application is approved, you won’t be required to report data for the performance category or categories included in your approved application. However, please note that a qualifying data submission will override approved reweighting on a category-by-category basis. We’ll score any qualifying data you, or someone on your behalf, submits and those performance categories will contribute to your final score.
How to Apply
To submit either Exception application:
Sign in to the QPP website with your Health Care Quality Information System (HCQIS) Access Roles and Profile (HARP) account.
Choose “Exceptions Application” from the left-hand navigation.
Click “Add New QPP Exception” on the right side of the screen.
Now Available: New APM Performance Pathway (APP) Resources
CMS recently posted new Quality Payment Program (QPP) resources about the APM Performance Pathway (APP), a reporting and scoring pathway for Merit-based Incentive Payment System (MIPS) eligible clinicians who participate in MIPS APMs.
2025 APP Fact Sheet: Provides an overview of the APP, including who can participate, reporting requirements, the scoring methodology, and frequently asked questions.
2025 APP Quick Start Guide: Shares guidance around data collection and submission requirements for the APP to help MIPS APM participants know what steps to take.
2025 APP Scoring Guide: Provides a general summary about scoring for the APP.
2025 APP Infographic: Outlines the APP for MIPS APM participants in 2025.
2025 APP Quality Requirements (All Participants, Excluding SSP ACOs) (ZIP, 17MB): Provides APP quality measure documentation for MIPS eligible clinicians, groups, and APM Entities, not including Shared Savings Program ACOs. Resources include APP quality data submission options, APP quality measure set details, and APP quality measure specifications.
2025 APP Quality Requirements (SSP ACOs Only) (ZIP, 12MB): Includes the APP quality measure documentation for Shared Savings Program ACOs. Resources detail data submission options, APP Plus quality measure set details, and APP Plus quality measure specifications.
Fourth Snapshot of 2024 Qualifying APM Participant (QP) Status and APM Participation Data Now Available in QPP Participation Status Tooldit this heading.
On April 4, the Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool based on the fourth snapshot of Alternative Payment Model (APM) data. The fourth snapshot includes data from Medicare Part B claims with dates of service between January 1, 2024, and December 31, 2024.
The tool includes 2024 Qualifying APM Participant (QP) status and Merit-based Incentive Payment System (MIPS) APM participation status.
To learn more about how CMS determines QP and the APM participation status for each snapshot, please visit the QPP website.
What Action Do I Need to Take?
Log into the QPP Portal and verify your Entity information.
If your information is inaccurate on the QPP website, contact the QPP helpdesk at QPP@cms.hhs.gov.
