Beginning with the 2024 performance period/2026 MIPS payment year, the targeted review period closes 30 days following the release of MIPS payment adjustments (refer to 42 CFR 414.1385(a)(2)).
Who Can Request a Targeted Review?
Individual clinicians, groups, subgroups, virtual groups, APM Entities (including Shared Savings Program ACOs), designated support staff and authorized third party intermediaries may request that CMS review their MIPS final score and MIPS payment adjustment factor through a process called targeted review.
When to Request a Targeted Review
Review your MIPS performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website. If you believe there’s an error in the calculation of your MIPS final score or MIPS payment adjustment factor, you can request a targeted review now until November 14, 2025, at 8 p.m. ET. Be advised that our ability to respond to inquiries and resolve requests will be delayed in most cases until normal government operations resume.
Examples of circumstances that could prompt a Targeted Review:
- Data were submitted under the wrong TIN or National Provider Identifier (NPI).
- You have Qualifying APM Participant (QP) status and shouldn’t receive a MIPS payment adjustment.
- Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.
Note: This isn’t a comprehensive list of circumstances.
How to Request a Targeted Review
To access your MIPS final score, performance feedback and request a targeted review:
- Sign in using your HARP credentials (ACO-MS credentials for Shared Savings Program ACOs); these are the same credentials that allowed you to submit your 2024 MIPS data and check your 2024 final score.
- Click “Targeted Review” on the left-hand navigation.
CMS may require documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required.
- 2024 Targeted Review User Guide (PDF, 2MB) – Reviews the process for requesting a targeted review and examples for when you would or wouldn’t request a targeted review. (We’re in the process of updating this resource with the Targeted Review deadline.)
Note: The federal government shutdown doesn’t affect your ability to submit a targeted review request by the above deadline, however it may affect our response time to resolve your request.
