ALERT: 2020 MIPS Hardship and Uncontrollable Circumstances Exemption Applications Now Available

MIPS-eligible clinicians and groups can now apply for the 2020 Promoting Interoperability (PI) Hardship Exception or the MIPS Program Extreme and Uncontrollable Circumstances Exception.

Applications must be submitted to CMS by December 31, 2020. It's easy to apply and applications are being processed in a timely fashion. Exceptions will be available to those who meet certain criteria established by CMS.

Tip: The 2020 application requires clinicians to provide a justification for why they should be excepted. To ensure a speedy review, applicants should specifically reference that they have been impacted by the COVID-19 public health emergency.

View the 2020 Quality Payment Program Exception Applications Fact Sheet.


Contact the Quality Payment Program at 1-866-288-8292, Monday through Friday, 8 am - 8 pm (EST) or by e-mail at Those who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

Your Academy is advocating for changes to the 2020 Reporting year as well. We will keep you informed of that progress. Email with any questions or concerns.

The cost category replaces the Medicare Value Modifier Program for eligible clinicians. Cost is responsible for 15% of your final MIPS score.



Cost is made up of 2 measures:

  • Medicare Spending Per Beneficiary (MSPB)—Evaluates Medicare Part A and B costs in the period
    immediately prior to, during, and following a patient’s hospital stay. This episode defined as 3 days prior to an inpatient hospitalization, the hospitalization itself, and 30 days after an inpatient hospitalization.Beneficiaries are attributed to the clinician that provided the plurality of all Part B services during the inpatient hospitalization, including the day of admission.
  • Total Per Capita Cost (TPCC)—Evaluates all Medicare Part A and B costs associated with any
    beneficiary over a year. This measure relies on a 2-step process that assigns a beneficiary to a single clinician based on the amount of primary care services received and the clinician specialties that perform these services.

While no additional reporting is necessary for the cost component of MIPS, AAPM&R has created a Cost Guide 2020 to help members understand how cost is attributed to their overall MIPS score. 

Quality & Practice

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