Upcoming Deadline to Appeal Your 2024 MIPS Score
The deadline to appeal 2024 MIPS scores and 2026 MIPS payment adjustments is rapidly approaching. The Centers for Medicare and Medicaid Services (CMS) refers to these appeals as “targeted reviews.” The deadline to submit a targeted review for the 2024 performance year is November 14, 2025, at 8 pm ET.
In this blog, we’ll review reasons you might want to submit a targeted review as well as how to do it.
What is a Targeted Review and Why Would I Submit One?
“Targeted review” is CMS’ term for an appeal of a MIPS score. Each year, the targeted review period is open for 30 days after the release of MIPS payment adjustments. During this window, you can review your score to make sure CMS has calculated your score correctly. If you believe CMS got it right, then great! Your work here is done, and you can expect your payment adjustment factor in the relevant payment year to reflect your hard work.
If you find an issue with CMS’ calculation of your score, you’ll need to submit a targeted review. Some examples of reasons to submit a targeted review are:
- Your data was submitted under the wrong NPI/TIN.
- You have a special status that wasn’t reflected in a performance category score.
- You were approved for a hardship exception, but it wasn’t applied.
- You were identified as a Qualifying APM Participant (QP), but you don’t belong to an APM.
While the above are all valid reasons for submitting a targeted review, not all reasons are considered legitimate by CMS. For example, you should not submit a targeted review for reasons such as confusion about scoring policy, not liking your payment adjustment, or disagreeing with benchmarking of measures.
How Do I Submit a Targeted Review?
If you are an Anatomy IT client, contact your MIPS Expert to complete this process for you.
If you are not an Anatomy IT client, submit a targeted review using the following steps:
- Sign in to your QPP account.
- Select “Targeted Review” on the left-hand navigation.
- Click “ADD NEW TARGETED REVIEW” and review the list of valid/invalid reasons for submission. Make sure to select “CONTINUE” after completing this step
- Select the type of application that reflects how your data was submitted (Individual, Group, APM Entity, Virtual Group, or Subgroup) and press “SAVE & CONTINUE.”
- Enter the submitter details (your contact information, TIN or NPI, etc.).
- Review the pre-populated information from the information you shared in step 5. Confirm your Reporting Option (Traditional MIPS, APM Performance Pathway, or MIPS Value Pathway) and enter any QPP service desk tickets you might have that are relevant to your targeted review (optional).
- You’ll need to provide contact information and your relationship to the party for whom you are submitting a targeted review. Note: use the same email you use for your QPP account, if possible.
- If you want anyone else to have access to information regarding your targeted review, you can enter their contact information before submitting.
- Select the affected Performance Categories for your targeted review. You can also review your performance feedback on this page.
- Select the “issue type” that is most relevant to your 2026 payment adjustment factor.
- Provide a detailed explanation of the issue. You can also add any additional documentation at this step.
- Note: if you don’t have your supporting documentation available as you are submitting, you can add it after submission by using the “Comments” function for up to 15 days after submission.
- Read the disclosure that summarizes your submission. If it is correct, then click “Certify & Submit.”
- Retain documentation of the targeted review for at least six years in case of an audit.
If you got this far in the instructions, congratulations! You have submitted your targeted review. You should receive an email confirming your submission. You’ll be able to monitor the progress of your targeted review anytime on the “Targeted Review Progress Summary” page. This page will allow you to track the status of your targeted review, as well as provide documentation (for up to 15 days post-submission) if necessary.
The length of time for a targeted review evaluation varies significantly, so while we can’t provide an estimate of when you’ll know the outcome of your review, we recommend monitoring its status on the QPP page regularly. If you have questions about your request, click “View Details” and communicate with your reviewer via the comments pane.
Next Steps
- Make sure to submit any targeted review requests by November 14, 2025, at 8 pm ET.
- Share this information with your colleagues.
- Subscribe to our blog to get alerts on this and other important issues. You can subscribe using the field in our website footer below.
- If you are an Anatomy IT client, contact your MIPS Expert if you have any questions.
- If you are not an Anatomy IT client, contact us to learn more about our MIPS Success Plan and to reap the rewards of our combined decades of experience.
If you have any questions on this, let us know!
Written By: Sarrah Hakim, MHSA
About the Author: Sarrah is a Manager of Health Policy at Anatomy IT.
