Physicians Advocacy Institute

Frequently Asked Questions Updated for 2021


3. What are the Virtual Group reporting requirements?

  1. The reporting requirements for each of the four MIPS categories are generally the same for Virtual Groups as they are for group reporting.
    • Quality - Report 6 applicable measures of which one must be an outcome measure or a high-priority measure if an outcome measure is not available. Alternatively, you have the option to report a specialty-specific measures set. See PAI’s Quality Category Overview for additional details.
    • Promoting Interoperability (PI) – Report at least 6 (required) out of the 11 applicable measures under the PI performance score. Under certain circumstances, you may claim an exclusion from specific measures. In this case, the scoring criteria will be reweighted, and the remaining measures you submit will have a larger impact on your overall PI performance score. See PAI’s PI Category Overview for additional details.
    • Improvement Activities - Report any combination of high and medium weight activities chosen from a list of 100 plus activities to achieve a total of 40 points for a 100% score for this category. See PAI’s Improvement Activities Category Overview for additional details.
    • Cost - No data reported; CMS will use the data from your Medicare claims to assess performance for the category. See PAI’s Cost Category Overview  for additional details.

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