Information Collection

Pqrs Ehr

IC 201579 under ICR 201309-0938-018 · 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⚠️ Notice: This information collection may be referencing outdated material.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
O - 2013_CMS_EHR_QRDA_Header_Error_Edits_04202012.xlsx	Other-CMS EHR QRDA
N - DRAFT 2013_CMS_EHR_QRDA_Data_Sub_Specs_04252012v4.1.pdf	Other-CMS EHR QRDA
A - 2012_PhysQualRptg_MeasuresList_122311.pdf A - 2012_PhysQualRptg_MeasuresList_122311	IC Document
B - 2012_PhysQualRptg_ImplementationGuide_01-13-2012.pdf B - 2012_PhysQualRptg_ImplementationGuide_01-13-2012	IC Document
C - DRAFT_2013_EHR_MeasureSpecifications_ReleaseNotes_3_21_2012_v4.0.pdf C - DRAFT_2013_EHR_MeasureSpecifications_ReleaseNotes_3_21_2012_v4.0	IC Document
D - DRAFT_2013_EHR_MeasureSpecifications_03_21_2012_v4.0.pdf D - DRAFT_2013_EHR_MeasureSpecifications_03_21_2012_v4.0	IC Document
E - DRAFT_2013_EHR_DownloadableResourceTable-032112_v4.0.xlsx E - DRAFT_2013_EHR_DownloadableResourceTable-032112_v4.0	IC Document
F - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0.pdf F - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0	IC Document
G - 2012_PhysQualRptg_MAV_ReleaseNotes_111011.pdf G - 2012_PhysQualRptg_MAV_ReleaseNotes_111011	IC Document
H - 2012_PhysQualRptg_MAV_ProcessforClaimsBasedReporting_111011.pdf H - 2012_PhysQualRptg_MAV_ProcessforClaimsBasedReporting_111011	IC Document
I - 2012_PhysQualRptg_MAV_Flow_111011.pdf I - 2012_PhysQualRptg_MAV_Flow_111011	IC Document
J - DRAFT_2013_EHR_DownloadableResourceTable-032112_v4.0.xlsx J - DRAFT_2013_EHR_DownloadableResourceTable-032112_v4.0	IC Document
K - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0.pdf K - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0	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_v4.1	IC Document
P - 2013_CMS_EHR_QRDA_Body_Error_Edits_04252012.xlsx P - 2013_CMS_EHR_QRDA_Body_Error_Edits_04252012	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

PQRS EHR

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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-CMS EHR QRDA					Yes	Yes	Fillable Fileable
Other-CMS EHR QRDA					Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

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: 15

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-15	15
Annual IC Time Burden (Hours)	-3,000	3,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
A - 2012_PhysQualRptg_MeasuresList_122311		10/12/2012
B - 2012_PhysQualRptg_ImplementationGuide_01-13-2012		10/12/2012
C - DRAFT_2013_EHR_MeasureSpecifications_ReleaseNotes_3_21_2012_v4.0		10/12/2012
D - DRAFT_2013_EHR_MeasureSpecifications_03_21_2012_v4.0		10/12/2012
E - DRAFT_2013_EHR_DownloadableResourceTable-032112_v4.0		10/12/2012
F - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0		10/12/2012
G - 2012_PhysQualRptg_MAV_ReleaseNotes_111011		10/12/2012
H - 2012_PhysQualRptg_MAV_ProcessforClaimsBasedReporting_111011		10/12/2012
I - 2012_PhysQualRptg_MAV_Flow_111011		10/12/2012
J - DRAFT_2013_EHR_DownloadableResourceTable-032112_v4.0		10/12/2012
K - DRAFT_2013_EHR_DownloadableResourceTable_ReleaseNotes_3_21_2012_v4.0		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_v4.1		10/12/2012
P - 2013_CMS_EHR_QRDA_Body_Error_Edits_04252012		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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