Improvement Activities

Quality & Practice

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Within the Quality Payment Program, there are 2 paths providers can choose and use to report quality data:

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.

To further support clinicians during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) is extending the 2020 Merit-based Incentive Payment Services (MIPS) Extreme and Uncontrollable Circumstances Exception application deadline to February 1, 2021. 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. Learn more about the deadline extension. 

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.


Improvement Activities (IA) was created to promote ongoing improvement and innovation. IA's account for 15% of your total MIPS score. 


In order to comply with 2020 reporting requirements, most eligible clinicians must attest to completing 4 activities for at least 90 days each. Eligible clinicians in small or rural practices may only need to complete 2. IA allow clinicians to choose the activities that are most meaningful to their practice to demonstrate performance. 


AAPM&R has created a MIPS Improvement Activity Guide to help members explore the activities that may be most applicable to the specialty.

All of your MIPS reporting can be completed using AAPM&R's Registry.

Use AAPM&R Practice Improvement Projects (PIPs) to Help with MIPS Reporting

Engagement in the Academy's Practice Improvement Projects (PIPs) can qualify as an Improvement Activity. By participating in MOC Part IV and engaging in an AAPM&R PIP for at least 90 consecutive days, (with a start date on or before October 2, 2019 and completion by December 31, 2019), you can attest to IA_PSPA_2: Participation in MOC Part IV.

AAPM&R offers 4 Practice Improvement Projects (PIPs):

Participants of each PIP are required to systematically review and document their activities, which CMS requires a monthly documentation for Quality Improvement Activities, to assess performance in practice by reviewing outcomes, addressing areas of improvement, and evaluating the results. 

Bonus: AAPM&R PIPs are FREE to Academy members, offer 20 CME, and help meet your Part IV American Board of Physical Medicine and Rehabilitation (ABPMR) Maintenance of Certification® requirement!

A few stipulations:

  1. You must be participating in Maintenance of Certification. Documentation may be required, should you be audited.
  2. You must perform the PIP consistently across your practice for a continuous period of at least 90 days during the MIPS measurement period (1/1/19 through 12/31/19. If you have already engaged in a PIP for a minimum of 90 consecutive days, or started your participation on or before October 2, 2019 and continue for 90 days, you can claim this IA.  
  3. If you are not using the AAPM&R Registry, you or your practice must attest to completion of this activity in 2019 via the CMS Web-Based Attestation Portal website—AAPM&R cannot do this for you. Although you will not be required to submit any supporting documentation to CMS at the time of attestation, you are encouraged to maintain documentation related to your completion of the PIP for at least 6 years in the event that CMS audits you to validate your performance. 

Additional information about the Improvement Activities category of MIPS, and other activities that might qualify, can be found at:  More detailed documentation requirements can be found in the MIPS Validation Criteria document in the QPP Resource Library at Questions? Feel free to contact AAPM&R at (847) 737-6000.