Information Collection

(Improvement Activities Performance Category) Data Submission (see SS-A Table 21)

IC 221785 under ICR 201911-0938-009 · OMB 0938-1314.

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Information Collection (IC) Details

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IC Title:	(Improvement Activities Performance Category) Data Submission (see SS-A Table 21)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR §414.1360 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Quality Payment Program (QPP), System No. 09â70â 0539	FR Citation: 83 FR 6587

Number of Respondents: 103,813	Number of Respondents for Small Entity: 103,813

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	103,813	-32,191	136,004
Annual IC Time Burden (Hours)	8,651	-2,683	11,334
Annual IC Cost Burden (Dollars)	0	0	0

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