Is Forming a Virtual Group to Meet Quality Program Requirements Right for Your Practice?

Solo practitioners and groups can choose to participate in the Merit-based Incentive Payment System (MIPS) as a virtual group for the 2018 performance period. To form a virtual group for 2018, solo practitioners and groups must follow an election process, and submit their election to the Centers for Medicare and Medicaid Services (CMS) by Dec. 31, 2017.

To be eligible to join a virtual group, you must be a:

  • Solo practitioner who exceeds the low-volume threshold; and who is not a newly Medicare-enrolled eligible clinician, a Qualifying APM Participant (QP), or a Partial QP choosing not to participate in MIPS.
  • Group that exceeds the low-volume threshold at the group level (i.e., the NPIs within the TIN collectively exceed the low-volume threshold) and has 10 or fewer clinicians (including at least one MIPS eligible clinician).

Not sure what this is all about? CMS is hosting a webinar offering an overview of virtual groups on Tuesday, Nov. 21 from 1 to 2 p.m. Learn more and register.

For more information about participating in MIPS as part of a virtual group, the election process and formal agreements, please see the Virtual Groups Toolkit or contact CMS through its Quality Payment Program Center at or 1-866-288-8292 (TTY: 1-877-715-6222).  Or, contact your local support organization.

The North Carolina Medical Society (NCMS) also may be able to help. If you are interested in forming a virtual group, please contact Belinda McKoy at or 919-833-3836 x142.


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