(Quality Performance Category) Claims Collection Type (see Table SS-A 10)

Quality Payment Program/Merit-Based Incentive Payment System (MIPS) (CMS-10621)

OMB: 0938-1314

IC ID: 221777

Documents and Forms
Document Name
Document Type
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Information Collection (IC) Details

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(Quality Performance Category) Claims Collection Type (see Table SS-A 10)
 
No Modified
 
Mandatory
 
42 CFR 414.1325 and 414.1335

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

257,260 257,260
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 257,260 0 0 -20,779 0 278,039
Annual IC Time Burden (Hours) 3,653,092 0 0 -1,296,002 0 4,949,094
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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