Virtual Group Election Period for MIPS 2021 Performance Year Now Open

Now Open: Virtual Group Election Period for the MIPS 2021 Performance Year

If you’re interested in forming a virtual group for the 2021 Merit-based Incentive Payment System (MIPS) performance year, the election period starts today. To form a virtual group, an election must be submitted to CMS via e-mail between October 1, 2020 and December 31, 2020 (11:59 p.m. Eastern Time).

NOTE: A virtual group must submit an election to CMS for each performance year that it intends to participate in MIPS as a virtual group (as required by statute). If your virtual group was approved for the 2020 MIPS performance year and intends to participate in MIPS as a virtual group for the 2021 MIPS performance year, your virtual group is still required to submit an election to CMS for the 2021 MIPS performance year between October 1, 2020 and December 31, 2020 (11:59 p.m. Eastern Time).

What Is a Virtual Group?

A virtual group is a combination of 2 or more Taxpayer Identification Numbers (TINs) consisting of the following:

Solo practitioners who are MIPS eligible (a solo practitioner is defined as the only clinician in a practice); and/or
Groups that have 10 or fewer clinicians (at least one clinician within the group must be MIPS eligible). A group is considered to be an entire single TIN.

A virtual group has the flexibility to determine its own makeup. A solo practitioner or group can only participate in one virtual group during the performance year.

What Are the Advantages of Participating in a Virtual Group?

Participating in MIPS as a virtual group has the following advantages:

Can increase performance volume in order to be reliably measured; and
Provides an opportunity for members of a virtual group to collaborate, share resources, and potentially increase performance under MIPS.

What Is the Virtual Group Election Process?

The following highlights key items that a virtual group needs to complete prior to the submission of an election:

Establish a formal written agreement between each TIN within the virtual group (see Agreement Sample Template in the Virtual Group Election Process Guide within the 2021 Virtual Group Toolkit).
Identify an official virtual group representative.

The following outlines the elements that need to be included in an election:

Acknowledgement that a formal written agreement has been established between each TIN within the virtual group.
The name and contact information for the official virtual group representative.
The name and TIN for each practice, and all associated National Provider Identifiers (NPIs) under each TIN.

Once complete, the virtual group must submit the election via e-mail to CMS at MIPS_VirtualGroups@cms.hhs.gov by 11:59 p.m. Eastern Time on December 31, 2020 (see Election E-mail Sample in the Virtual Group Election Process Guide within the 2021 Virtual Group Toolkit).

For further information regarding virtual group participation in MIPS, virtual group reporting requirements, the election process, checklists for virtual groups to consider, and sample templates, download the 2021 Virtual Group Toolkit.

Need Help?

Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, please consider calling during non-peak hours—before 10 a.m. and after 2 p.m. Eastern Time.
- Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.
Connect with your local technical assistance organization. We provide no-cost technical assistance to small, underserved, and rural practices to help you successfully participate in the Quality Payment Program.

QPP: 2020 MIPS Quality Measures Impacted by the Annual ICD-10 Coding Update

Quality Payment Program: 2020 Performance Period Merit-based Incentive Payment System (MIPS) Quality Measures Impacted by the Annual ICD-10 Coding Update

In the Calendar Year (CY) 2018 Quality Payment Program Final Rule (82 FR 53714 through 53716), Centers for Medicare & Medicaid (CMS) finalized the policy allowing for the review of quality measures for significant impacts due to ICD-10 coding changes during the performance period. Performance for these quality measures will be assessed based only on the first 9 months of the 12-month performance period.

For the 2020 MIPS performance period, CMS has not identified any quality measures requiring performance data to be suppressed for the last quarter of the performance period due to the annual ICD-10 code update.

Additional information regarding this policy can be found in the 2020 MIPS Quality Measures Impacted by ICD-10 Updates located on the QPP Resource Library.

If you have questions regarding the ICD-10 impact analysis, please contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (Monday-Friday 8 a.m. - 8 p.m. ET).