New MIPS Option Now Available

Every day, you are faced with options: Should I wear this outfit or that one? Should I go to the gym before work or after? Is another slice of pie really the best thing for me right now?

If you want even more options, you're in luck. The Centers for Medicare & Medicaid Services (CMS) has added another way to participate in the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program.

For the 2018 performance year, solo physicians and small group practices will be able to band together to join MIPS as a — get this — "virtual group." 

Wow.

The new "virtual" option is voluntary, and physicians still can choose to participate as an individual or as a group. 

Each virtual group will be a combination of two or more taxpayer identification numbers (TINs) made up of the following:  

  • A solo practitioner who’s eligible to participate in MIPS and bills under a TIN with no other National Provider Identifiers (NPIs) billing under the TIN; or
  • A group with 10 or fewer eligible clinicians (at least one must be eligible for MIPS) that joins with at least one other solo practitioner or group for a performance period of a year. 

According to the 2018 Quality Payment Program proposed rule, the MIPS data-reporting requirements for virtual groups will be similar to the "real" group-level requirements.

But this option won’t be available for long: If you want to participate, you must name an official representative who will submit the group's election to CMS by email by Dec. 31.

CMS will publish final policies and criteria surrounding virtual groups in the 2018 Quality Payment Program final rule this month.

You also can download the 2018 Virtual Groups Toolkit on the CMS website. If you still have questions, contact the CMS Quality Payment Program Service Center at (866) 288-8292 or by email

For no-cost technical assistance, contact the TMF Health Quality Institute or submit an online help request. As always, visit the TMA MACRA Resource Center to stay up to date on the latest information. 

Action, Nov. 1, 2017

Note: This article has been updated to show that the deadline to participate as a virtual group has been extended to Dec. 31.

Last Updated On

November 13, 2017

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