Reporting Options

Individual Reporting

An individual is a clinician identified by their National Provider Identification (NPI) and tied to a single Taxpayer Identification Number (TIN). Individuals collect data and report measures based on their own performance, and their payment adjustment will be based on their final MIPS score.

Group Reporting

A group is a single TIN with two or more clinicians – one of whom must be MIPS eligible – as identified by their NPI, who have reassigned their Medicare billing rights to a TIN. A group reports their activities and measures based on the aggregate performance of all the clinicians billing under the TIN. Note that if a clinician is not eligible for MIPS at the individual level, but they are eligible at the group, they are not required to report at the group level. However, if the TIN chooses to report at the group level, the individual clinician will receive the score of the group.

Individual/Group Reporting

A virtual group is comprised of two or more TINs that elect to form a virtual group. Virtual groups will aggregate their performance data across all TINs to receive their MIPS final score. Virtual group reporting is optional.

Virtual Group Reporting

An APM Entity participates in an APM or other payor arrangement through a direct agreement with CMS, other payor, or through state or federal law or regulation. APM Entities aggregate their performance for all clinicians for the Quality and Improvement Activities performance categories. They can submit Promoting Interoperability data at the group or individual level.

Alternative Payment Model (APM) Entity Reporting