• MIPS 2020—Reweighting the MIPS Performance Categories

    This content is excerpted from EyeNet’s MIPS 2020; also see the Academy’s MIPS hub page.


    CMS can reweight how performance categories contribute to your MIPS final score. For ophthalmologists, the most typical reweighting scenarios are:

    TABLE: Performance Category Weights

    “Extreme and Uncontrollable” Circumstances

    What if circumstances beyond your control limit your ability to participate in MIPS? 

    You can apply for an “extreme and uncontrollable” reweighting. You can apply to have your performance categories reweighted if you have difficulty reporting one or more performance categories due to “extreme and uncontrollable circumstances.” In past years, CMS started reviewing applications in the fall. The application period will close on Dec. 31, 2020. 

    During a widespread catastrophe, CMS may waive the application requirement for individuals. For example, if the Federal Emergency Management Agency declares a major disaster or public health emergency, CMS may decide to implement an automatic extreme and uncontrollable circumstances policy, which would mean that affected clinicians could have their performance categories reweighted without having to go through the application process. However, this automated reweighting would only be applied to individuals; if you are reporting as part of a group, your group would have to apply for the reweighting.

    Note: In some years, CMS has not been able to publish a list of affected areas eligible for an automatic exemption before the end of the calendar year. If you are in a disaster zone, and your area hasn’t yet been flagged as eligible for an automatic exemption, consider applying for an “extreme and uncontrollable circumstances” reweighting before you miss the Dec. 31 deadline. 

    What is considered extreme and uncontrollable? It must be a rare event that is entirely outside of the control of yourself and of the facility where you work. The circumstances must prevent you—either altogether or for an extended period of time—from collecting information that you need to submit for a performance category. For example, a fire that destroys the only facility where a clinician works could be considered extreme and uncontrollable, but the inability to renew a lease for that facility wouldn’t. CMS will take into account the type of event, date of event, length of time over which the event took place, and other pertinent details that might impact your ability to report each performance category. 

    How performance categories are reweighted. If CMS approves your application to reweight one or more performance categories to zero, they would be reweighted. (See “Table: Performance Category Weights.”)

    IMPORTANT: Don’t submit data to CMS on performance categories that are accepted for reweighting. CMS will not reweight a performance category if you reported data for that category after the triggering extreme and uncontrollable event.

    Previous: Your MIPS Final Score

    Next: Performance Periods 

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