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Centers for Medicare & Medicaid Services Quality Payment Program
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* Reminder: 2024 MIPS Value Pathway (MVP) Registration Closes December 2 [ #link_1 ]
* 2025 Merit-based Incentive Payment System (MIPS) Performance Year Virtual Group Election Period [ #link_2 ]
* Reminder: 2024 QPP Exception Applications are Available [ #link_3 ]

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Reminder: 2024 MIPS Value Pathway (MVP) Registration Closes December 2

The Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) registration window for the 2024 performance year is open. Individuals, groups, subgroups, and Alternative Payment Model (APM) Entities [ https://qpp.cms.gov/apms/mips-apms ] that wish to report an MVP can register *until December 2, 2024, at 8 p.m. ET.*  

*NEW FOR 2024: *To register, you’ll sign in to the QPP website [ https://qpp.cms.gov/ ] with your HCQIS Access and Roles Profile (HARP) account. This is different from the 2023 process of completing an Excel form and emailing the QPP Service Center.  

You must have a HARP account and QPP Security Official role to complete the MVP Registration.  


* For more information on HARP accounts, please refer to the Register for a HARP Account document in the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2955/QPP-Access-User-Guide.zip ].   
* For more information on obtaining the QPP Security Official role, review the Connect to an Organization document in the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2955/QPP-Access-User-Guide.zip ]. 

*Prepare for MVP Registration*  

Before you register, you’ll need to have the following items identified:  


* The MVP you plan to report; 
* Whether you plan to administer the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey, if it’s a quality measure option in your selected MVP; 
* Whether you want to be evaluated on an outcomes-based administrative claims quality measure, if it’s a quality measure option in your selected MVP; 
* The population health measure you would like to be evaluated on:  
* 2024 Hospital-Wide All-Cause Unplanned Readmission Measure or 
* 2024 Clinician and Clinician Group Risk-standardized Hospital Admission Rates for Patients with Multiple Chronic Conditions 

* The participation option you plan to use: individual, group, subgroup, or APM Entity. 

*How to Register*  

Individuals, groups, subgroups and APM Entities will register on the Quality Payment Program (QPP) website. You'll need to have the Security Official role in order to register your organization. Please refer to the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2955/QPP-Access-User-Guide.zip ] for information about obtaining a Security Official role for your organization. To register:  


* Sign in to QPP 
* Click Register or edit an MVP registration from the landing page 
* Click your MVP reporting option 

*Note: If the CAHPS for MIPS Survey is an available measure in your selected MVP and you wish to administer it as 1 of your 4 required measures, you should have completed a separate CAHPS for MIPS Survey registration by July 1, 2024. Visit the QPP website to learn more about CAHPS for MIPS Survey registration [ https://qpp.cms.gov/mips/how-to-register-for-CAHPS ].  

*Additional Resources*  


* 2024 MVPs Implementation Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2778/2024-MVPs-Implementation-Guide.pdf ] 
* 2024 MVPs Registration Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2750/2024MVPRegistrationGuide.pdf ] 
* 2024 Explore MVPs [ https://qpp.cms.gov/mips/explore-mips-value-pathways ] 

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2025 Merit-based Incentive Payment System (MIPS) Performance Year Virtual Group Election Period

If you’re interested in forming a virtual group for the 2025 MIPS performance year [ https://qpp.cms.gov/mips/virtual-group-participation?py=2025 ], the election period is now open. To form a virtual group, an election must be submitted to CMS via email at MIPS_VirtualGroups@cms.hhs.gov by *December 31, 2024* *(11:59 p.m. ET)*. 

*Is a Virtual Group Required to Submit an Election to Participate in MIPS for the 2025 MIPS Performance Year? * 

Yes, a virtual group must submit an election to CMS for each performance year it intends to participate in MIPS as a virtual group. Refer to *§ 414.1315* [ https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-O/section-414.1315 ]. 

If your virtual group was approved for the 2024 MIPS performance year and intends to participate in MIPS as a virtual group for the 2025 MIPS performance year, your virtual group must still submit an election to CMS for the 2025 MIPS performance year between *October 1, 2024*, and *December 31, 2024 (11:59 p.m. ET).*   

*What is a Virtual Group? * 

A virtual group is a combination of 2 or more Taxpayer Identification Numbers (TINs) consisting of: 


* Solo practitioners (defined as the only clinician in a practice) who are MIPS eligible [ https://qpp.cms.gov/mips/how-eligibility-is-determined ]; and/or 
* Groups that have 10 or fewer clinicians (at least one clinician within the group must be MIPS eligible). A group is considered to be an entire single TIN. 

A virtual group has the flexibility to determine its own makeup. 

A solo practitioner or group can only participate in one virtual group during the performance year. 

*How Can I Benefit from Participating in a Virtual Group?* 

*You can:  * 


* Collaborate, share resources, and potentially increase your performance under MIPS.
* Increase performance volume so you can be reliably measured. 

*What is the Virtual Group Election Process?* 

A virtual group must do the following prior to submitting an election: 


* Establish a formal written agreement between each TIN within the virtual group (see Agreement Sample Template in the 2025 MIPS Virtual Group Election Process Guide within the 2025 MIPS Virtual Group Toolkit (ZIP, 2 MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3009/2025-MIPS-Virtual-Group-Toolkit.zip ]). 
* Identify an official virtual group representative. 

The following elements must be included in an election: 


* Acknowledge that a formal written agreement has been established between each TIN within the virtual group. 
* The name and contact information for the official virtual group representative. 
* The name and TIN for each practice, and all associated National Provider Identifiers (NPIs) under each TIN. 

Once the above is complete, the virtual group must submit the election to CMS via email at MIPS_VirtualGroups@cms.hhs.gov by *11:59 p.m. ET on December 31, 2024* (see Election Email Sample in the 2024 MIPS Virtual Group Election Process Guide within the 2025 Virtual Group Toolkit (ZIP, 2 MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3009/2025-MIPS-Virtual-Group-Toolkit.zip ]). 

Please note that the 2025 Virtual Group Toolkit (ZIP, 2 MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3009/2025-MIPS-Virtual-Group-Toolkit.zip ] contains additional helpful information regarding virtual group participation in MIPS, virtual group reporting requirements, the election process, checklists for virtual groups to consider, and sample templates. 

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Reminder: 2024 QPP Exception Applications are Available

The 2024 Quality Payment Program (QPP) Exception applications are available through *December 31, 2024, at 8 p.m. ET*. There are 2 types of exception applications that allow users to indicate the reason they’re unable to report data for one or more Merit-based Incentive Payment System (MIPS) performance categories. 

*MIPS Promoting Interoperability Performance Category Hardship Exception Application* 

Individual clinicians, groups, and virtual groups (or a third-party representative) can submit a MIPS Promoting Interoperability Performance Category Hardship Exception application for the following reasons: 


* You have decertified Electronic Health Record (EHR) technology (must be decertified under the Office of the National Coordinator for Health Information Technology’s (ONC) Health IT Certification Program). 
* You have insufficient internet connectivity. 
* You face extreme and uncontrollable circumstances such as a disaster, practice closure, severe financial distress, or vendor issues. 
* You lack control over the availability of certified EHR technology (CEHRT). 

This application is specific to the MIPS Promoting Interoperability performance category. If your application is approved, you won’t be required to report data for this performance category. 

*MIPS Extreme and Uncontrollable Circumstances Exception Application* 

Individual clinicians, groups, and virtual groups (or a third-party representative) can submit a MIPS Extreme and Uncontrollable Circumstances (EUC) Exception application for one or more MIPS performance categories (quality, cost, improvement activities, and Promoting Interoperability) due to extreme and uncontrollable circumstances, defined as rare events entirely outside of your control and the control of the facility in which you practice. 

These circumstances would: 


* Cause you to be unable to collect information necessary to submit for a MIPS performance category. 
* Cause you to be unable to submit information that would be used to score a MIPS performance category for an extended period of time (for example, if you were unable to collect data for the quality performance category for 3 months). 
* Impact your normal processes, affecting your performance on cost measures and other administrative claims measures. 

Alternate Payment Model (APM) Entities can submit applications as well, but they must apply for all performance categories. 

If your application is approved, you won’t be required to report data for the performance category or categories included in your approved application. However, please note that data submission overrides approved reweighting on a category-by-category basis.  We’ll score any data you, or someone on your behalf, submits and those performance categories will contribute to your final score. 

*How to Apply* 

To submit either Exception application: 


* Sign in to the QPP website [ https://qpp.cms.gov/login ] with your Health Care Quality Information System (HCQIS) Access Roles and Profile (HARP) account. 
* Choose “Exceptions Application” from the left-hand navigation. 
* Click “Add New QPP Exception” on the right side of the screen. 
* Choose your exception type. 

*Additional Resources* 


* Quality Payment Program Access User Guide (ZIP, 3MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2955/QPP-Access-User-Guide.zip ] – Refer to “Step 1: Register for a HARP Account” 
* Exception Applications (webpage on the QPP website) [ https://qpp.cms.gov/mips/exception-applications?py=2024 ]  
* 2024 MIPS Promoting Interoperability Hardship Exception Application Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2846/2024-MIPS-PI-Hardship-Exception-Application-Guide.pdf ]  
* 2024 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2845/2024-MIPS-EUC-Exception-Application-Guide.pdf ] 

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