The Centers for Medicare and Medicaid Services (CMS) recently announced that physicians participating in the Merit-based Incentive Payment System (MIPS) who have been adversely impacted by the Southern California fires will be covered under the "Extreme and Uncontrollable Circumstances" policy for both the 2024 and 2025 performance periods.

This policy grants MIPS-eligible clinicians exceptions without having to submit an exception request. Physicians in the affected areas will be automatically identified and have all 4 performance categories reweighted to 0% during the data submission period for the 2024 performance period (January 2 to March 31, 2025) and 2025 performance period (January 2 to March 31, 2026). This will result in a score equal to the performance threshold. 

However, if MIPS eligible clinicians in these areas submit data on 2 or more performance categories for either/both performance years, they’ll be scored on those performance categories and receive a payment adjustment based on their MIPS final score. 

The automatic extreme and uncontrollable circumstances policy will not apply to MIPS eligible clinicians in MIPS Alternative Payment Models (APMs), or to those participating in MIPS as groups, subgroups or virtual groups. However, groups, virtual groups, and APM entities can request reweighting through the EUC exception application. Subgroups will inherit any reweighting approved for their affiliated group; they can’t request reweighting independent of their affiliated group’s status. 

For More Information 

Please reference the MIPS EUC Exception section on the Quality Payment Program Exception Applications webpage and 2024 MIPS Automatic EUC Policy Fact Sheet (PDF, 401KB) and 2025 MIPS Automatic EUC Policy Fact Sheet (PDF, 326KB).

For More Information

• MIPS Exception Application Page
• 2024 MIPS Automatic EUC Policy Fact Sheet (PDF)
• 2025 MIPS Automatic EUC Policy Fact Sheet (PDF)

Physicians with questions can contact the Medicare Quality Payment Program at (866) 288-8292 or QPP@cms.hhs.gov.