Information Collection

Pqrs Ehr

IC 201579 under ICR 201211-0938-004 · OMB 0938-1059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1059 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
N - DRAFT 2013_CMS_EHR_QRDA_Data_Sub_Specs_04252012v4.1.pdf	Other-N - DRAFT 2013_CMS_EHR_QRDA_Da
O - 2013_CMS_EHR_QRDA_Header_Error_Edits_04202012.xlsx	Other-O - 2013_CMS_EHR_QRDA_Header_E
C - DRAFT_2013_EHR_MeasureSpecifications_ReleaseNotes_3_21_2012_v4.0.pdf C - DRAFT_2013_EHR_MeasureSpecifications_ReleaseNotes_3_21_2012_v4	IC Document
D - DRAFT_2013_EHR_MeasureSpecifications_03_21_2012_v4.0.pdf D - DRAFT_2013_EHR_MeasureSpecifications_03_21_2012_v4	IC Document
K - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0.pdf K - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4	IC Document
L - DRAFT 2013_EHR_DownloadableResourceTable_Other_Resource_Codes_Mar_2012.xlsx L - DRAFT 2013_EHR_DownloadableResourceTable_Other_Resource_Codes_Mar_2012	IC Document
M - DRAFT 2013_CMS_EHR_QRDA_Data_Sub_Specs_Release_Notes_04252012_v4.1.pdf M - DRAFT 2013_CMS_EHR_QRDA_Data_Sub_Specs_Release_Notes_04252012_v4	IC Document

IC Title:

PQRS EHR

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 414.90 42 CFR 414.92

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-N - DRAFT 2013_CMS_EHR_QRDA_Data_Sub_Specs_04252012v4.1					Yes	Yes	Printable Only
Other-O - 2013_CMS_EHR_QRDA_Header_Error_Edits_04202012					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Performance Measurement and Reporting System

FR Citation: 72 FR 52133

Number of Respondents: 16,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,000	15,985	15
Annual IC Time Burden (Hours)	144,000	141,000	3,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
C - DRAFT_2013_EHR_MeasureSpecifications_ReleaseNotes_3_21_2012_v4		10/12/2012
D - DRAFT_2013_EHR_MeasureSpecifications_03_21_2012_v4		10/12/2012
K - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4		10/12/2012
L - DRAFT 2013_EHR_DownloadableResourceTable_Other_Resource_Codes_Mar_2012		10/12/2012
M - DRAFT 2013_CMS_EHR_QRDA_Data_Sub_Specs_Release_Notes_04252012_v4		10/12/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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