Information Collection Request

Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)

ICR 202005-0938-002 · OMB 0938-1343 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10652 MIPS: Virtual Group Election Process Form and Instruction Modified Repair queued
CMS-10652 VG for MIPS Supporting Statement A (02-03-20).docx Supporting Statement A Uploaded 2020-05-07 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228101 MIPS: Virtual Group Election Process Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 01/31/2021
16 16
160 160
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
MIPS: Virtual Group Election Process CMS-10652 Virtual Group Agreement Template

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16 16 0 0 0 0
Annual Time Burden (Hours) 160 160 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No