Information Collection

§414.1440 Other Payer Advanced APM Identification: Other Payer Initiated Process

IC 227509 under ICR 201808-0938-005 · OMB 0938-1314.

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Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10621 Clinician Initiated Submission Form §414.1440 Other Payer Advanced APM Identification: Other Payer Initiated Process	Form and Instruction
Form CMS-10621 Payer Initiated Submission Form §414.1440 Other Payer Advanced APM Identification: Other Payer Initiated Process	Form and Instruction
CMS-10621 Clinician Initiated Submission Form Appendix D Clinician Initiated Submission Form (CR)_final_.docx	Form and Instruction
CMS-10621 Payer Initiated Submission Form Appendix E Payer Initiated Submission Form.pdf	Form and Instruction
Crosswalk_Payer Submission Form_Amended.docx Crosswalk Payer Submission Form	IC Document
non-substantive change Appendix D Clinician Initiated Submission Form (CR)_redline_.pdf Appendix D - redline	IC Document

Record metadata
IC Title	§414.1440 Other Payer Advanced APM Identification: Other Payer Initiated Process