MIPS Reporting Guide

Individual

A clinician submits their own individual performance data. Can report:
Traditional MIPS

APM Performance Pathway (APP) (must be a MIPS APM Participant)
MIPS Value Pathway (MVP)

Group

A practice submits performance data on behalf of all clinicians billing under the tax identification number (TIN). Can report:
Traditional MIPS

APM Performance Pathway (APP) (must be a MIPS APM Participant)
MIPS Value Pathway (MVP)

Virtual Group

A CMS-approved virtual group is a number of providers not under any given TIN, but come together “virtually” to form a group for reporting purposes only. Can report:

Traditional MIPS

Subgroup

A subgroup is a subset of clinicians in a group (at least 2 clinicians) which contains at least one individually eligible MIPS eligible clinician. Can report:

MIPS Value Pathway (MVP) (requires advance registration)

APM Entity

MIPS eligible providers that are MIPS APM participants. Can report:
Traditional MIPS

APM Performance Pathway (APP) (must be a MIPS APM Participant)
MIPS Value Pathway (MVP)

Physicians (including doctors of medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry) • Osteopathic practitioners • Chiropractors • Physician assistants • Nurse practitioners • Clinical nurse specialists • Certified registered nurse anesthetists • Physical therapists • Occupational therapists • Clinical psychologists • Qualified speech-language pathologists • Qualified audiologists • Registered dietitians or nutrition professionals • Clinical social workers • Certified nurse midwives

TOUCH

Be considered a MIPS eligible clinician and be required to report data to MIPS

mips-university-check-mark-white

TOUCH

Receive performance feedback

TOUCH

Receive a MIPS payment adjustment (positive, negative, or neutral)

TOUCH

Be eligible to have your data publicly reported on the Doctors and Clinicians section of Care Compare (formerly “Physician Compare”)

TOUCH

Be assessed in the same way as MIPS eligible clinicians who are required to participate in MIPS

Ambulatory Surgical Center (ASC) – based

Automatic reweighting of the Promoting Interoperability performance category to 0%

Hospital – based

Automatic reweighting of the Promoting Interoperability performance category to 0%

Non-patient facing

Automatic reweighting of the Promoting Interoperability performance category to 0% and earn 2x points for Improvement Activities under traditional MIPS

Small practices

Automatic reweighting of the Promoting Interoperability performance category to 0% and earn 2x points for Improvement Activities under traditional MIPS

Rural

Earn 2x points for Improvement Activities under traditional MIPS

HPSA (Health Professional Shortage Area)

Earn 2x points for Improvement Activities under traditional MIPS

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Your Guide to 2024 MIPS Reporting

Participation Options

Individual

Group

Virtual Group

Subgroup

APM Entity

Eligible Clinician Types

Low Volume Threshold (LVT)

Eligible clinicians and groups may opt-in if they meet at least one of the LVT criteria

Special Status

QPP automatically assigns special statuses to MIPS eligible clinicians, practices, virtual groups, and APM Entities who meet certain criteria. Special status may affect reporting requirements.

Performance Category Weighting

Performance Thresholds

to avoid a negative adjustment of -9%

Data Completeness

Available Bonus Points

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