In the MIPS program, the Promoting Interoperability (PI) category replaces the Medicare Electronic Health Records (EHR) Incentive Program (Meaningful Use) and is intended to promote patient engagement and the electronic exchange of information using certified EHR technology (CEHRT). MIPS-eligible clinicians may earn a score of up to 155 points but any score above 100 will be capped at 100 points.




The PI score is the combined total of the following three scores:

    1. 50 points: Required Base Score

    2. 90 points: Performance Score

    3. 15 points: Bonus Score (up to 15 points)


The bonus and performance scores are added to the base score to get the total PI score. The PI total score is multiplied by the 25% PI category weight with the result added to the overall MIPS final score.


Example: If a MIPS-eligible clinician receives the base score (50 points), 40 points for their performance score and no bonus score, they would earn an PI score of 90 points. When weighted by 25%, this would contribute 90 X 0.25 = 22.5 points to their overall MIPS final score.


Clinicians must use Certified Electronic Health Record Technology (CEHRT) to qualify for reporting PI information. Qualifying clinicians may choose from a variety of methods for submitting PI measures:


Individual Reporting

Group Reporting

  • Attestation

  • QCDR

  • Qualified Registry

  • EHR Vendor

  • Attestation

  • QCDR

  • Qualified Registry

  • EHR Vendor

  • CMS Web Interface (groups of 25 or more)


CMS will automatically reweight certain clinicians based on their special statuses. MIPS-eligible clinicians and groups may also submit a hardship exception application for one of the following specified reasons: ACI Clinicians Automatically Reweighted

  • Insufficient internet connectivity

  • Extreme and uncontrollable circumstances                            

  • Lack of control over the availability of Certified EHR Technology (CEHRT)


If you’re applying for a hardship exception based on the Extreme and Uncontrollable Circumstance category, you must select one of the following and provide a start and end date of when the circumstance occurred:

  • Disaster (e.g., a natural disaster in which the CEHRT was damaged or destroyed)

  • Practice or hospital closure

  • Severe financial distress (bankruptcy or debt restructuring)

  • EHR certification/vendor issues (CEHRT issues)


You must submit an exception application to CMS by December 31, 2018, to reweight the PI category to 0 if you do not automatically qualify for a reweighting. Qualifying clinicians can choose to report PI if they wish and CMS will score their performance and weight their PI performance.