Physicians enrolled in the Quality Payment Program (QPP) can now apply for an exception to the scoring process.
The exception application is due Dec. 31 at 7 pm CT, per the Centers for Medicare & Medicaid Services (CMS).
Physicians unable to report data for one or more Merit-Based Incentive Payment System (MIPS) performance categories – Promoting Interoperability, Cost, Quality, and Improvement Activities – and who wish to have those categories reweighted in their evaluation can apply for two separate exceptions.
QPP participants granted exceptions for 2026 will see them reflected in their 2028 Medicare payment.
To request reweighting for the Promoting Interoperability performance category, physicians must:
- Have electronic health record (EHR) technology that is decertified under the Office of the National Coordinator for Health Information Technology’s Health IT Certification Program;
- Have insufficient internet connectivity;
- Face extreme and uncontrollable circumstances such as a disaster, practice closure, severe financial distress, or vendor issues; or
- Lack control over the availability of certified EHR technology.
The second pathway, the MIPS Extreme and Uncontrollable Circumstances (EUC) exception, allows QPP physicians to request reweighting for all four performance categories in the case of what CMS classifies as “rare events entirely outside of your control and the control of the facility in which you practice.” It is available to those in MIPS, MIPS Value Pathway, or the APM Performance Pathway. Qualifying events must:
- Prevent a physician from collecting the information needed to submit for a MIPS performance category;
- Prevent a physician from submitting information that would be used to score a MIPS performance category for an extended period (for example, if unable to collect data for the quality performance category for three months); or
- Impact a physician’s normal processes and performance on cost measures and other administrative claims measures.
MIPS-eligible clinicians located in a region affected by an extreme and uncontrollable circumstances event, such as a Federal Emergency Management Agency-designated major disaster, automatically receive the EUC exception. Per CMS, physicians in this group are automatically identified and don’t need to submit an exception application. All MIPS performance categories reweighted to 0% unless data is submitted for two or more performance categories.
Learn more about QPP via the Texas Medical Association’s MACRA Resource Center.
Last Updated On
May 27, 2026
Originally Published On
May 27, 2026
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.