Information Collection Request

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

ICR 202007-0938-007 · OMB 0938-1314 · Historical Inactive

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
243257 Nomination of MVPs (SS-A Table 21) Form and Instruction New
243256 Open Authorization Credentialing and Token Request Process (SS-A Table 5) New
233582 Submission of Data for All-Payer QP Determinations under the All-Payer Combination Option (see SS-A Table 25) Form Modified
233581 QPP Identity Management Application Process (see SS-A Table 9) Unchanged
229086 (Quality Performance Category) Call for Quality Measures (see SS-A Table 13) Form and Instruction Modified
229075 Other Payer Advanced APM Identification: Clinician Initiated Process (see SS-A Table 24) Form Modified
229074 (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 17) Form and Instruction Modified
227511 (Physician Compare) Opt Out for Voluntary Participants (see SS-A Table 26) Modified
227509 Other Payer Advanced APM Identification: Payer Initiated Process (see SS-A Table 23) Form and Instruction Modified
227507 (Improvement Activities Performance Category) Nomination of Improvement Activities (see SS-A Table 20) Form Modified
227506 (PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 14) Form Modified
227505 (Quality Performance Category) Group Registration for CMS Web Interface (see SS-A Table 14) Instruction Removed
221786 Partial Qualifying APM Participant (QP) Election (see SS-A Table 22) Modified
221785 (Improvement Activities Performance Category) Data Submission (see SS-A Table 19) Modified
221784 (PI Performance Category) Data Submission (see SS-A Table 16) Modified
221782 Self-nomination: QCDR and Qualified Registry (see SS-A Tables 3 and 4) Instruction Modified
221781 (Quality Performance Category) CMS Web Interface Submission Type (see SS-A Table 13) Removed
221780 (Quality Performance Category) eCQM Collection Type (see SS-A Table 12) Modified
221779 (Quality Performance Category) QCDR/MIPS CQM Collection Type (see SS-A Table 11) Modified
221777 (Quality Performance Category) Claims Collection Type (see SS-A Table 10) Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2022 36 Months From Approved 01/31/2022
475,198 0 475,198
2,937,891 0 2,937,891
0 0 0





Reginfo record details
18
table that charts list of burden
IC Title Form No. Form Name
(PI Performance Category) Data Submission (see SS-A Table 16)
Other Payer Advanced APM Identification: Clinician Initiated Process (see SS-A Table 24) CMS-10621 Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form)
Submission of Data for All-Payer QP Determinations under the All-Payer Combination Option (see SS-A Table 25) CMS-10621 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option
(PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 17) CMS-10621 Promoting Interoperability Performance Category: Call for Measures Submission Form
QPP Identity Management Application Process (see SS-A Table 9)
(Improvement Activities Performance Category) Nomination of Improvement Activities (see SS-A Table 20) CMS-10621 Improvement Activities Performance Category: Call for Activities Submission Form
Other Payer Advanced APM Identification: Payer Initiated Process (see SS-A Table 23) CMS-10621 Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form)
(Quality Performance Category) QCDR/MIPS CQM Collection Type (see SS-A Table 11)
(Quality Performance Category) Claims Collection Type (see SS-A Table 10)
(Quality Performance Category) eCQM Collection Type (see SS-A Table 12)
Self-nomination: QCDR and Qualified Registry (see SS-A Tables 3 and 4) CMS-10621 2020 Qualified Clinical Data Registry (QCDR) Measure Submission Template
(Improvement Activities Performance Category) Data Submission (see SS-A Table 19)
Partial Qualifying APM Participant (QP) Election (see SS-A Table 22)
(PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 14) CMS-10621, CMS-10621 Hardship Exception Application Form ,   Extreme and Uncontrollable Circumstances Application Form
(Physician Compare) Opt Out for Voluntary Participants (see SS-A Table 26)
(Quality Performance Category) Call for Quality Measures (see SS-A Table 13) CMS-10621, CMS-10621 Data Template for Candidate Measures ,   Measures under Consideration 2019, Data Template for Candidate Measures
(Quality Performance Category) CMS Web Interface Submission Type (see SS-A Table 13)
(Quality Performance Category) Group Registration for CMS Web Interface (see SS-A Table 14)
Open Authorization Credentialing and Token Request Process (SS-A Table 5)
Nomination of MVPs (SS-A Table 21) CMS-10621 MVP Candidates: Instructions and Template



Reginfo record details
  No