Information Collection Request

CAHPS Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)

ICR 201606-0938-002 · OMB 0938-1222 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10450 CAHPS for MIPS Survey Form and Instruction Modified Available
CAHPS for MIPS Supporting Statement Part B_0660616.docx Supporting Statement B Uploaded 2016-06-07 Available
CMS-10450 CAHPS for MIPS Supporting Statement Part A 0660616.docx Supporting Statement A Uploaded 2016-06-07 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
206234 CAHPS for MIPS Survey Form and Instruction Modified

ICR Details

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table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2017 36 Months From Approved 04/30/2017
117,300 0 117,300
39,530 0 39,530
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
CAHPS for MIPS Survey CMS-10450, CMS-10450, CMS-10450 CAHPS for MIPS Survey ,   CAHPS for MIPS Survey Script ,   CAHPS for MIPS Attestation



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  No