Merit-Based Incentive Payment System (MIPS) physicians in 21 Texas counties affected by July’s severe storms and flooding have been granted an exception resulting in a neutral payment adjustment in 2027 for the 2025 performance year.
The Extreme and Uncontrollable Circumstances (EUC) exception will automatically identify affected MIPS participants and reweight their scores in all four performance categories to 0% for the 2025 data submission period.
The Centers for Medicare & Medicaid Services (CMS) issued the MIPS EUC, designated for “rare events” affecting a practice’s “normal processes.”
This exception will apply to participants in Burnet, Coke, Concho, Edwards, Hamilton, Kendall, Kerr, Kimble, Lampasas, Llano, Mason, McCulloch, Menard, Real, Reeves, San Saba, Schleicher, Sutton, Tom Green, Travis, and Williamson counties.
If a MIPS physician from one of the affected counties submits data for two categories for 2025, CMS will score the physician on those categories and determine a 2027 payment adjustment based on those scores. In other words, it is worthwhile to submit data if you believe your scores will result in a positive payment adjustment, Texas Medical Association staff say.
CMS notes the automatic EUC policy doesn’t apply to physicians participating in MIPS as members of a group, virtual group, or alternative payment model entities in those three categories can request reweighting through the EUC exception application on the Quality Payment Program (QPP) website, due by 7 pm CT on Dec. 31.
Subgroups, however, will inherit any reweighting for the group they belong to, and cannot request reweighting independent of that group.
Download the EUC policy fact sheet for more information, and learn more about QPP via TMA’s MACRA Resource Center.
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.