MIPS defines a group practice as a single Tax Identification Number (TIN) with two or more individual clinicians (as identified by Individual National Provider Identifier [NPI]) that have reassigned their billing rights to the TIN. If clinicians wish to report as a group, they must register their TIN with CMS to report MIPS data through the group practice reporting option (GPRO) by June 30 of the reporting year through the CMS Enterprise portal.
During registration, groups can select the mechanism they wish to report quality data, e.g. GPRO Web-Interface or Qualified Registry/Qualified Clinical Data Registry (QCDR).
MIPS Criteria for Groups:
VIA GPRO WEB-INTERFACE:
Quality - must report on all 15 quality measures available in the Web-Interface tool for FULL calendar year. 2018 MIPS Group Web-Interface Measures List. Clinicians already reporting on quality measures through an APM, no further action needed, but please consult with your APM entity. MIPS Measures for Allergists.
Advanced Care information - Fulfill at least the following required 5 from the 15 available objectives/measures for a minimum of 90 days:
1. Security Risk Analysis
3. Provide patient access
4. Send summary of care
5. Request/accept summary of care
Fulfill up to 9 objective/measures for a minimum of 90 days for additional credit
Group must have a certified EHR system, 2014 or 2015 edition, or a combination of the two to meet the objectives. Check if your EHR vendor is certified HERE.
Improvement Activities – Attest for at least 4 improvement activities for a minimum of 90 days (rural practitioners or groups with < 15 providers attest to at least 2 activities). There are over 90 activities to choose from: List of Improved Activities. If you participate in an Advanced APM (Alternative Payment Model), automatically earn full credit. In any other APM, automatically ear half-credit in this category.
VIA QUALIFIED REGISTRY/QCDR - Same criteria as Web-Interface, except for the Quality category:
Quality - Report up to 6 quality measures (MIPS and/or non-MIPS measures), include at least one outcome measure for a minimum of 90 days, and at least 60% of the clinician’s eligible patients.
With the AAAAI QCDR, you can meet all three MIPS categories criteria that require reporting (Quality, Advanced Care Information, and Improvement Activities). Pricing details available at www.aaaai.org/qcdr.
NEW! VIA VIRTUAL GROUP - is a combination of two or more TINs. There must be at least 1 MIPS eligible clinician for the TIN to participate. TINs can be from any specialty as long as they agree to report together. There is a CMS election process to participate in a virtual group. Find full details on the Virtual Group Factsheet and Election Process.