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Specifically, in addition to extending the deadline for submitting MIPS data, we announced on April 6, 2020, that, due to the COVID-19 PHE, we would apply our extreme and uncontrollable circumstances reweighting policies described under 414.1380(c)(2)(i) to MIPS eligible clinicians nationwide and extend the deadline to submit an application for reweighting the quality, cost, improvement activities or Promoting Interoperability performance categories for the CY 2019 performance period/2021 MIPS payment year (85 FR 19277 and 19278)

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They can occur due to mild or benign conditions such as muscle fatigue after exercising or pregnancy