MIPS Participation Eligibility and Exclusions Pages MIPS Participation Eligibility and Exclusions 1. How will the low volume exclusion be determined – at the individual or the group level? 2. Is the low-volume threshold for allowed charges or Medicare paid amount? 3. Are physicians and other eligible clinicians who practice in Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) exempt from MIPS? 4. For the purposes of the MIPS exemption, does the low-volume threshold apply to Medicare Advantage patients too? 5. Medicare Part B revenue for each physician in my group is less than $90,000 annually, but collectively, the group exceeds this amount. How will CMS determine if my group is exempt from MIPS? 6. If I choose the test option and submit data for one quality measure/one patient via claims submission today, can I change my mind and report data for a 90-day period later in the year using claims or a different reporting method? 7. When will CMS notify individuals who are exempt in 2018? 8. Even if I am exempt from MIPS participation, can I still report? If so, am I eligible for / subject to an adjustment? What are the pros and cons of reporting if exempt? 9. Is the low-volume threshold based on what was billed / number of patients seen in 2017, or will it be 2018? 10. If we are a group of 4 physicians and as a group TIN we do not meet the low volume qualifications, but individually we all qualify as low volume, can we elect to report individually and avoid MIPS? 11. What happens if I change practices? Comments are closed.