Thinking of Forming a MIPS Virtual Group for 2020?

Deadline to Notify CMS of Intent to Participate Is Dec. 31

November 06, 2019 01:30 pm News Staff

Family physicians who want to form a virtual group for CMS' 2020 Merit-based Incentive Payment System performance year must follow the agency's election process and submit email notification to CMS by Dec. 31.

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Virtual groups give solo and small group practices -- those with 10 or fewer clinicians -- another reporting option under MIPS.

The AAFP supports virtual groups because they level the playing field between small and large practices by allowing small independent practices to pool their patient data with that of other practices; doing so gives those participants a better shot at success in the MIPS program.

CMS defines a virtual group(qpp.cms.gov) as a combination of two or more taxpayer identification numbers assigned to

  • one or more solo practitioners who are MIPS-eligible,
  • one or more groups consisting of 10 or fewer clinicians that include at least one MIPS-eligible clinician, or
  • a combination of solo practitioners and groups of 10 or fewer clinicians that elect to form a virtual group for a yearlong performance period.

Physicians with questions about whether they meet the size criteria to form a virtual group should contact their Quality Payment Program Technical Assistance organization(qpp.cms.gov) for guidance.

In addition, clinicians and/or groups who participate in the virtual group election process will be required to

  • create a formal written agreement among all participants,
  • name an individual to represent the virtual group,
  • determine the group's size and low-volume threshold, and
  • email notification to CMS.

Questions? Download CMS' 2020 Virtual Groups Toolkit(qpp-cm-prod-content.s3.amazonaws.com) to learn more.

Physicians can also get help by emailing the QPP or by calling 866-288-8292 for immediate assistance. CMS advises physicians to avoid calling the QPP phone line between 10 a.m. and 2 p.m. ET, if possible, because that time frame encompasses peak service hours.

More From AAFP
MACRA Basics: Merit-based Incentive Payment System

Additional Resource
CMS Quality Payment Program(qpp.cms.gov)