3. Are physicians and other eligible clinicians who practice in Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) exempt from MIPS? Those in Critical Access Hospitals (CAHs) are not exempt from MIPS reporting. Physicians and other eligible clinicians who bill exclusively through their FQHC, CHC, or Rural Health Clinics (RHC) are exempt from MIPS reporting, but they can choose to voluntarily report (without being subject to a payment adjustment). If they bill under the Medicare Physician Fee Schedule (the traditional Medicare fee schedule), they are subject to participation in MIPS unless they meet one of the following exemptions. The following eligible clinicians are exempt from participation in MIPS: Newly-enrolled Medicare eligible clinicians who enroll in Medicare for the first time during the performance year Eligible clinicians and groups that are below the low-volume threshold: Who have Medicare Part B allowed charges < $90,000 OR Who provide care to 200 or fewer Medicare Part B patients Provide 200 or fewer covered professional services to Part B patients Use the CMS NPI lookup tool to help you determine your eligibility. To use the tool, you will need to know your 10-digit national provider identification (NPI) number. Eligible clinicians who are participating in Advanced APMs Pages MIPS Participation Eligibility and Exclusions1. How will the low volume exclusion be determined – at the individual or the group level?2. Is the low-volume threshold for allowed charges or Medicare paid amount?3. Are physicians and other eligible clinicians who practice in Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) exempt from MIPS?4. For the purposes of the MIPS exemption, does the low-volume threshold apply to Medicare Advantage patients too?5. Medicare Part B revenue for each physician in my group is less than $90,000 annually, but collectively, the group exceeds this amount. How will CMS determine if my group is exempt from MIPS?6. When will CMS notify individuals who are exempt in 2020?7. Even if I am exempt from MIPS participation, can I still report? If so, am I eligible for / subject to an adjustment? What are the pros and cons of reporting if exempt?8. Is the low-volume threshold based on what was billed / number of patients seen in 2019, or will it be 2020?9. If we are a group of 4 physicians and as a group TIN we do not meet the low volume qualifications, but individually we all qualify as low volume, can we elect to report individually and avoid MIPS?10. What happens if I change practices? Comments are closed.