2019 MIPS Program: Small vs Large Practice

The Centers for Medicare & Medicaid Services (CMS) designates small practices as those that have 15 or fewer clinicians; and therefore, have special allowances under the Merit-based Incentive Payment System (MIPS) in order to reduce burden on small practices. This includes varying submission methods and special scoring considerations as illustrated here.

For all practices, regardless of size, Quality is 85% of the overall MIPS score and individuals or groups must meet the Quality category reporting requirements:

  • Report a minimum of 6 measures
  • One must be an outcome or high priority measure
  • 12-month reporting period
  • 60% data completeness (60% of all patients, regardless of payer, that meet the measure denominator)*
  • 20 case minimum per measure

*The only exception is for measures submitted via Medicare Part B claims, in which case, pathologists must submit data on 60% of all Medicare Part B patients that meet the measure denominator during the performance period.

Small Practices
(≤15 pathologists)
Large Practices
(>15 pathologists)
Submission Methods
  • Medicare Part B Claims
  • Registry Submission
  • Registry Submission ONLY
Data Completeness (Quality Category)Failure to meet:
  • 60% data completeness
Will result in 3 points for the measure
Failure to meet:
  • 60% data completeness
Will result in 1 point for the measure
Bonus Points for Small Practices6 bonus points automatically added to the Quality category if data for at least 1 quality measure is submittedNone

Pathologists Quality Registry

Optimize your performance in MIPS and enroll for the 2020 reporting period.

Learn more about the registry Right Arrow

We have a dedicated team to help you navigate to MIPS reporting success.

Email: mips@cap.org 

Phone: 800-323-4040, option 3