On June 24, CMS announced that physician practices can opt out of the 2020 MIPS program using the Extreme and Uncontrollable Circumstances Application "if the COVID19 pandemic is preventing you from collecting data for an extended period of time, or could impact your performance on cost measures. Approved applications will reweight performance categories to 0%." CMS offers physicians the following options on the hardship exemption application: a practice can indicate that they do not want to be scored on Cost and Quality and have their score calculated based on just Promoting Interoperability and Improvement Activities. Alternatively, practices can opt-out of all four performance categories and be held harmless from a 2022 payment adjustment. Submitting any MIPS data to CMS will override the hardship exception application and physicians will be scored on their submission.