MIPS FAQs
- There has been confusion about what counts towards the low-volume threshold. Does this included Medicare billings or Medicare allowed charges?
Medicare allowed charges, which includes the 80% Medicare pays and the 20% covered by cost-sharing. - What is the advantage of reporting as a group vs individual?
The most important thing to know about this question is that each NPI and TIN must report on the same measures and will receive the same score if reporting as a group. The group should evaluate the score at a group level and an individual level to see what will be most beneficial for the clinicians. - How does a clinician in a multi-specialty group select the measures for each reporting period?
If the clinician is part of a practice that is reporting as a group, the clinicians along with the administration should meet and select measures based on what is best for all areas of the practice. If the clinician is reporting as an individual, he or she can report on whatever measures they would like. - Do solo physicians need to participate in MIPS?
Yes, they are subject to the same rules as other physicians. Visit the QPP website to see if you qualify for the program. - What are the MIPS requirements for a non-patient facing clinician?
These physicians have fewer requirements than clinicians with traditional face-to-face visits. A guide can be found here.
