Individual or Group Participation

If you're included in MIPS, you'll need to decide whether you will send in MIPS data as an individual or with a group.

Check Your Participation Status

Report as an individual

If you report as an individual, your payment adjustment will be based on your performance.

An individual is defined as a single clinician, identified by a single National Provider Identifier (NPI) number tied to a single Tax Identification Number (TIN).

You'll need to send your individual data for each of the MIPS categories through an electronic health record or a registry. You can also send in quality data through your routine Medicare claims process.

For 2018, you’ll be able to pick from a list of ways to submit (some options vary based on performance category), including:

  • Qualified Clinical Data Registry (QCDR)
  • Qualified registry
  • Electronic Health Record (EHR)
  • Administrative claims
  • Attestation

Report with a group

Each eligible clinician participating in MIPS via a group will receive a payment adjustment based on the group's performance.

Under MIPS, a group is defined as a single Taxpayer Identification Number (TIN) with 2 or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their National Provider Identifiers (NPI), who have reassigned their Medicare billing rights to the TIN.

For 2018, groups are able to choose from a list of available data submission mechanisms (some options vary based on performance category) including:

  • CMS Web Interface (only available to groups with 25 or more eligible clinicians)
  • Qualified Clinical Data Registry (QCDR)
  • Qualified Registry
  • Electronic Health Record (EHR)
  • CAHPS for MIPS Survey (only available to groups with 2 or more eligible clinicians)
  • Attestation

Between April 1 through June 30, 2018, registration is open for groups planning to participate in MIPS via the CMS Web Interface or Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS survey. Only these 2 submission options require registration.

Learn about group registration >