Medicare Promoting Interoperability Program Hardship Exception Application

Date: May 25, 2022

Medicare Promoting Interoperability Program Hardship Exception Application

Centers for Medicare and Medicaid Services (CMS)
September 1, 2022
Contact or 866.288.8912

CMS eligible hospitals and Critical Access Hospitals (CAHs) may be exempted from the Medicare Promoting Interoperability payment adjustment if they can show that compliance with the requirement for being a meaningful Electronic Health Record (EHR) user would result in a significant hardship. Eligible hospitals and CAHs may submit a hardship exception application each year for a maximum of 5 years.

Reasons for a hardship exception include:

  • Using decertified EHR technology
  • Insufficient internet connectivity
  • Extreme and uncontrollable circumstances
  • Lack of control over the availability of certified electronic health record technology (CEHRT)

2022 Quality Payment Program Exceptions Application Fact Sheet


CMS eligible hospitals and CAHs that can cite one of the reasons listed above may apply for a hardship exception.

Amount of funding

If approved, the hardship exception is valid for one payment adjustment year. Eligible hospitals and CAHs would need to submit a new application for subsequent years, and no entity can be granted an exception for more than 5 years.

Application process

Links to additional guidance and the online hardship exception application is available on the program website.