Medicare QPP

Physicians Advocacy Institute

These resources have not been updated since 2023 but the general details remain relevant. For a summary of the key changes for CY 2024, please click here.

Frequently Asked Questions Updated for 2023

rss

7. I’m associated with, and bill under, different NPI/TIN combinations, do I have to report data to MIPS under each one/practice?

  1. Yes, generally, each NPI/TIN combination is subject to participation in MIPS. However, it is possible that one or more of the NPI/TIN combinations may be exempt from MIPS participation due to the low-volume threshold or participation in an Advanced APM.

    It is recommended that you use the CMS lookup tool to determine your eligibility status. To use the tool, you will need to know your 10-digit national provider identification (NPI) number.
     
    If you participate in an Advanced APM under one NPI/TIN combination and you receive a qualifying participant (QP) determination, you are exempt from MIPS participation for all other NPI/TIN combinations. To learn more about the QP determination and Advanced APM participation, please see the QPP Advanced APM Overview



Comments are closed.