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

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8. 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?

  1. You can choose to report individually and be exempt from MIPS participation or as a group and be subject to MIPS participation; however, all physicians in your group must participate in the same manner. For example, in a practice of 10 physicians all under the same TIN, the practice can elect to participate at the group level (the group of 10 physicians would collectively have to meet the specific requirements for each category) or decide that each of the 10 physicians would report as individual physicians (each physician would have to meet the specific requirements for each category). Half the physicians in the group cannot participate as individuals and be exempt while the other half participate as a group and are subject to MIPS participation. In this case, even if half of the physicians participate in MIPS as a group, the MIPS performance score and payment adjustment would be applied to all physicians under that group TIN.



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