Due to the ongoing impact of the COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) will continue to allow physicians and group practices to apply for a MIPS Extreme and Uncontrollable Circumstances hardship exception to avoid up to a -9% MIPS penalty in 2025 based on 2023 performance. The exception will not be automatic; therefore, interested physicians and groups must actively request reweighting of one or more MIPS performance categories due to the PHE. Requesting reweighting of all four MIPS performance categories will avoid a MIPS penalty in 2025. CMS expects to release the hardship exception application in spring 2023.