MIPS Eligible Clinician Types: Complete List
CMS recognizes about 15 clinician types as MIPS eligible for the 2026 performance year. The list runs from physicians and physician assistants to nurse practitioners, therapists, clinical social workers, and registered dietitians.
CMS reads your clinician type from the specialty codes on Medicare Part B claims under each Taxpayer Identification Number and National Provider Identifier (TIN/NPI). You must exceed the low-volume threshold and avoid other exemptions to report MIPS. Being an eligible type is necessary but not sufficient.
What Is a MIPS Eligible Clinician?
A MIPS eligible clinician is a clinician whose professional type appears on the CMS MIPS-eligible list. That clinician must also exceed the low-volume threshold without qualifying for an exemption. Eligibility rests on a three-part test: the correct clinician type, volume above the threshold, and no applicable exemption.
CMS reads each clinician type from the specialty codes on Medicare Part B claims. The MIPS term “eligible clinician” is not the legacy term “eligible professional” from Meaningful Use. Those two terms describe different programs and should not be used interchangeably.
How Does CMS Determine Your Clinician Type?
CMS determines your clinician type from the specialty codes on the Medicare Part B claims billed under your TIN/NPI combination. CMS assigns type at the TIN/NPI level, meaning per clinician per practice.
A clinician who bills under two Tax Identification Numbers holds two separate evaluations. Each TIN/NPI combination receives its own clinician-type reading and its own eligibility result.
Does Being An Eligible Clinician Type Mean You Must Report Mips?
No. Being an eligible clinician type is necessary but not sufficient. You are required to report MIPS only if you also exceed all three low-volume-threshold criteria and avoid other exemptions. Common exemptions include a new Medicare enrollee or a Qualifying APM Participant.
How Do Eligible Clinicians Fit Into The Mips Eligibility Criteria?
The clinician-type list is the first of three eligibility tests CMS applies. The full criteria add the low-volume threshold and the exemption checks. This page owns the type question. It states the other two tests as the border and hands the detail to the parent hub.
- Clinician type: your specialty type appears on the CMS MIPS-eligible list.
- Low-volume threshold: your Part B volume exceeds all three threshold criteria, which are ($90,000 earned in performance year, 200 services & 200 Medicare Part B patients).
- Exemption check: you are not a new enrollee, a QP, or otherwise excluded.
Only clinicians who clear all three tests are required to report MIPS. The MIPS eligibility criteria hub covers the full framework, including the threshold math and the exemption rules.
Which Clinician Types Are Mips Eligible?
CMS recognizes about 15 clinician types as MIPS eligible for the 2026 performance year. The table below lists each type, its acronym, and the year it joined the MIPS-eligible list. The four groups that follow organize these types by clinical function.
| Clinician Type | Acronym | Included Since |
|---|---|---|
| Physicians (MD, DO, DDS, DMD, DPM, OD) | MD / DO / DDS / DMD / DPM / OD | 2017 |
| Osteopathic practitioners | N/A | 2017 |
| Chiropractors | PA | 2017 |
| Physician assistants | PA | 2017 |
| Nurse practitioners | NP | 2017 |
| Clinical nurse specialists | CNS | 2017 |
| Certified registered nurse anesthetists | CRNA | 2019 |
| Physical therapists | PT | 2019 |
| Occupational therapists | OT | 2019 |
| Qualified speech-language pathologists | SLP | 2019 |
| Qualified audiologists | AUD | 2019 |
| Clinical psychologists | N/A | 2019 |
| Registered dietitians / nutrition professionals | RD | 2019 |
| Clinical social workers | CSW | 2022 |
| Certified nurse-midwives | CNM | 2022 |
Physicians And Doctoral Providers (Md, Do, Dds, Dmd, Dpm, Od, Chiropractors)
CMS groups several doctoral degrees under the physician category. This group covers doctors of medicine (MD) and doctors of osteopathy (DO), including osteopathic practitioners. It also covers dental degrees (DDS, DMD), podiatric medicine (DPM), and optometry (OD). Chiropractors also count as MIPS eligible clinician types. All have been eligible since the 2017 program launch.
Advanced-Practice And Nursing Clinicians (Pa, Np, Cns, Crna, Cnm)
This group covers advanced-practice and nursing clinicians. It includes physician assistants (PA), nurse practitioners (NP), and clinical nurse specialists (CNS). It also includes certified registered nurse anesthetists (CRNA) and certified nurse-midwives (CNM). CMS added certified nurse-midwives to the MIPS-eligible list for the 2022 performance year.
Therapy And Rehabilitation Clinicians (Pt, Ot, Slp, Audiologists)
This group covers therapy and rehabilitation clinicians. It includes physical therapists (PT), occupational therapists (OT), qualified speech-language pathologists (SLP), and qualified audiologists. CMS added all four therapy types to the MIPS-eligible list for the 2019 performance year. Many therapy clinicians bill low Medicare volume and fall below the reporting threshold.
Behavioral-Health And Nutrition Clinicians (Clinical Psychologists, Clinical Social Workers, Rd/Nutrition Professionals)
This group covers behavioral-health and nutrition clinicians. It includes clinical psychologists, clinical social workers (CSW), and registered dietitians or nutrition professionals (RD). CMS added clinical psychologists and registered dietitians for the 2019 performance year. CMS added clinical social workers to the MIPS-eligible list for the 2022 performance year.
Do Nurse Practitioners And Physician Assistants Qualify For Mips?
Yes. Nurse practitioners (NP) and physician assistants (PA) are both MIPS-eligible clinician types. Like every eligible type, an NP or PA is required to report only after exceeding the low-volume threshold under their TIN/NPI.
An NP or PA below the threshold is exempt but may opt in. CMS evaluates each NP and PA separately at every practice they bill under.
Do Therapists And Psychologists Qualify For Mips?
Yes. Physical therapists (PT), occupational therapists (OT), qualified speech-language pathologists (SLP), and clinical psychologists are all MIPS-eligible clinician types. Each type is required to report only after exceeding the low-volume threshold. Many therapy clinicians and psychologists bill low Part B volume. Those below the threshold are exempt or may opt in.
Which Clinicians Are Not Mips Eligible?
Being on the CMS list does not guarantee a reporting requirement. Four groups fall outside MIPS eligibility for the 2026 performance year. The four exclusion zones below cover each case.
Clinician Types Not On The Cms List
Clinicians whose specialty type does not appear on the CMS list are excluded from MIPS. These clinicians receive no MIPS payment adjustment. The specialty codes on their Medicare Part B claims determine this outcome.
New Medicare Enrollees (On Or After January 1, 2026)
Clinicians who enroll in Medicare for the first time on or after January 1, 2026 are excluded from MIPS for the 2026 performance year. The exclusion lasts until the clinician has a full year of Medicare Part B billing history.
Clinicians Below The Low-Volume Threshold
Clinicians who do not exceed all three low-volume-threshold criteria are not required to report MIPS. The three criteria are Part B allowed charges, Part B beneficiaries, and covered professional services. The low-volume threshold page explains each criterion and the exact 2026 values.
Qualifying APM Participants (QPs)
Clinicians who reach Qualifying APM Participant (QP) status through an Advanced Alternative Payment Model are exempt from MIPS. A QP earns Advanced APM incentives instead of a MIPS payment adjustment. CMS makes QP determinations several times each performance year.
How And When Does Cms Determine Your Mips Eligibility?
CMS determines MIPS eligibility at the TIN/NPI level across two determination periods each performance year. Each review analyzes a separate 12-month segment of Medicare Part B claims. The two 2026 review windows appear below.
| Determination Review | Claims / Data Period | Status Released |
|---|---|---|
| First 2026 review | October 1, 2024 – September 30, 2025 | December 2025 |
| Second 2026 review | October 1, 2025 – September 30, 2026 | Late 2026 |
A clinician found exempt in the first 2026 review is not required to report MIPS. CMS pulls enrollment data from the Provider Enrollment, Chain, and Ownership System (PECOS). A virtual group must elect its status before the performance year begins.
Can You Opt In To Mips If You Are Below The Low-Volume Threshold?
Yes, in part. A clinician who exceeds one or two of the three low-volume-threshold criteria may opt in to MIPS. The opt-in runs through an irrevocable election in the QPP portal. An opt-in clinician becomes a MIPS-eligible clinician and earns a payment adjustment.
A clinician who exceeds none of the three criteria cannot opt in. That clinician may still report voluntarily without any payment adjustment.
How Does Macralytics Verify Your Mips Eligibility?
Macralytics confirms each clinician’s MIPS eligibility before the reporting year begins. The process follows four steps.
- Check the clinician type for each TIN/NPI against the CMS list.
- Run the low-volume-threshold math on Part B claims.
- Flag exemptions and opt-in options for each clinician.
- Advise on the lowest-burden reporting path.
A MIPS eligibility check confirms status at the TIN/NPI level before the reporting year.
CMS recognizes about 15 MIPS eligible clinician types for 2026, from physicians to clinical social workers. The clinician type is only the first test. Eligibility also depends on the low-volume threshold, the new-enrollee rule, and QP status.
Confirm all of these before you plan your MIPS reporting year. The MIPS eligibility criteria hub covers the full framework in one place.
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