Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)

CMS is requesting clearance for the statutorily required virtual group election process proposed in the CY 2018 Quality Payment Program proposed rule. As outlined in section 1848(q)(5)(I)(iii) of the Social Security Act (hereafter the Act) as amended by section 101 of MACRA, a virtual group is a combination of TINs, which would include at least two separate TINs associated with a solo practitioner (TIN/NPI) or group with 10 or fewer MIPS eligible clinicians and another solo practitioner (TIN/NPI) or group with 10 or fewer MIPS eligible clinicians. In the CY 2018 Quality Payment Program proposed rule, we propose that once the election request is approved by CMS, each virtual group will receive a virtual group identifier that will be used for purposes of virtual group submission of quality, advancing care information, and improvement activities performance category data on behalf of its participating clinicians. We also propose to use the virtual group identifier for calculation of a final score and the associated MIPS payment adjustment for the virtual group, and to provide performance feedback for each virtual group.

The latest form for Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652) expires 2021-01-31 and can be found here.