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What are the requirements for participation in a virtual group?

Solo practitioners have to:

  • Be a practice of one MIPS eligible clinician, who is:
    • Not newly Medicare-enrolled.
    • Not a QP Participant.
    • Not a Partial QP not choosing to participate in MIPS.
    • Not excluded from MIPS based on the low-volume threshold exclusion at the individual level.
  • Have at least one other solo practitioner or group of 10 or fewer eligible clinicians (including at least one MIPS eligible clinician) as part of the virtual group.

Groups have to:

  • Have a TIN size that’s not more than 10 eligible clinicians;
  • Not be excluded from MIPS based on the low-volume threshold exclusion at the group level; and
  • Have at least one solo practitioner or other group of 10 or fewer eligible clinicians (including at least one MIPS eligible clinician) as part of the virtual group.
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