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  • MIPS 2023—Table: Promoting Interoperability Exclusions at a Glance

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    This content is excerpted from EyeNet’s MIPS 2023: A Primer and Reference; also see the Academy’s MIPS hub page.

    Table: PI Exclusions at a Glance

    Exclusions available for some measures. If you successfully claim an exclusion for a PI measure, the points available for that measure will be reassigned to one or more other PI measures as shown below (see column 4).
    2023 PI Measure Points Exclusion Points Reallocation if Exclusion Applies

    Objective: e-Prescribing
    e-Prescribing Up to 10 points Exclusion: “Any MIPS eligible clinician who writes fewer than 100 permissible prescriptions during the performance period.” The 10 points (or 20 points if you claim an exclusion for both of this objective's measures) would be distributed to the HIE objective.
    Query of Prescription Drug Monitoring Program (PDMP) 0 or 10 points Exclusion: 1) if you write fewer than 100 permissible prescriptions during the performance period and/or 2) if you are unable to prescribe Schedule II, III, and IV drugs in accordance with applicable law and/or—for 2023 only—3) if querying a PDMP “would impose an excessive workflow or cost burden” prior to the start of your PI performance period. The 10 points would be redistributed to the e-Prescribing measure.

    Objective: Health Information Exchange (HIE)
    Support Electronic Referral Loops by Sending Health Information Up to 15 points Exclusion: “Any MIPS eligible clinician who transfers a patient to another setting or refers a patient [a combined total of] fewer than 100 times during the performance period.” The 15 points (or 30 points if you claim an exclusion for both Referral Loops measures) would be redistributed to the Provider to Patient Exchange objective.
    Support Electronic Referral Loops by Receiving and Incorporating Health Information Up to 15 points

    Exclusion: “Any MIPS eligible clinician who receives transitions of care or
    referrals or has patient encounters in which the MIPS eligible clinician has never before encountered the patient [a combined total of] fewer than 100 times during the performance period.” (Note: It is unlikely that a large practice would fall below this threshold over 90 days.)

    		 The 15 points would be redistributed to the Support Electronic Referral Loops by Sending Health Information measure.
    HIE Bi-Directional Exchange 0 or 30 points

    No exclusion available; if you don't report this measure or the TEFCA measure, you can instead report (or claim an exclusion for) the two Support Electronic Referral Loops measures.

    		  
    Enabling Exchange Under the Trusted Exchange Framework and Common Agreement (TEFCA) 0 or 30 points

    No exclusion available; if you don't report this measure or the HIE Bi-Directional Exchange measure, you can instead report (or claim an exclusion for) the two Support Electronic Referral Loops measures.

    Objective: Provider to Patient Exchange
    Provide Patients Electronic Access to Their Health Information Up to 25 points No exclusion available.  

    Objective: Public Health and Clinical Data Exchange

    Immunization Registry Reporting
    and/or
    Electronic Case Reporting

    		 0 or 25 points

    Immunization Registry Reporting measure: You can qualify for an exclusion if one or more of these three criteria applies:
    • “Does not administer any immunizations to any of the populations for which data is collected by its jurisdiction’s immunization registry or immunization information system during the performance period.”
    • “Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required to meet the CEHRT definition at the start of the performance period.”
    • “Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data as of 6 months prior to the start of the performance period.”

    Electronic Case Reporting measure: You can qualify for an exclusion if one or more of these four criteria applies:
    • “Does not treat or diagnose any reportable diseases for which data is collected by their jurisdiction’s reportable disease system during the performance period.”
    • “Operates in a jurisdiction for which no public health agency is capable of receiving electronic case reporting data in the specific standards required to meet the CEHRT definition at the start of the performance period.”
    • “Operates in a jurisdiction where no public health agency has declared readiness to receive electronic case reporting data as of six months prior to the start of the performance period.”
    • For 2022 only: You use CEHRT that is not certified to the electronic case reporting certification criterion prior to the start of the performance period that you select.

    If you claim exclusions for both the Immunization Registry Reporting measure and the Electronic Case Reporting measure, the 25 points are redistributed to
    the Provide Patients Electronic Access to Their Health Information measure.

    Public Health Registry Reporting
    or
    Clinical Data Registry Reporting
    or
    Syndromic Surveillance Reporting

    		 0 or 5 bonus points (You earn the same number of bonus points [5] whether you report one, two, or all three measures.)

    No exclusion is needed for these optional bonus measures. (Note: You are eligible for these bonus points even if you claim exclusions for both the Immunization Registry Reporting measure and the Electronic Case Reporting measure.)

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