Mail Survey Crosswalk

Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Survey for the Merit-Based Incentive Payment System (MIPS)
Survey Instructions
CY 2019 Final versus CY 2021 Final
Burden impact: The changes to this CAHPS for MIPS survey reflect policies in the CY2021
Physician Fee Schedule (PFS) Final Rule for the Quality Payment Program (QPP) and result in
an estimated increase of 0.2 minutes per beneficiary to complete the one additional question
added to the survey.
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Change #1
Location:
Survey Instructions
Reason for change:
Instruct patients to include telehealth visits due to the increasing use of telehealth during
the public health emergency.
2019 script:
This survey asks about you and the health care you received in the last six months.
Answer each question thinking about yourself. Please take the time to complete this
survey. Your answers are very important to us. Please return the survey with your
answers in the enclosed postage-paid envelope to [VENDOR NAME]

2021 script:

This survey asks about you and the health care you received in the last six months
during visits that were in-person, by phone or by video call. Answer each question
thinking about yourself. Please take the time to complete this survey. Your answers are
very important to us. Please return the survey with your answers in the enclosed
postage-paid envelope to [VENDOR NAME]

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Change #2
Location:
Item Q40
Reason for change:
Instruct patients to include telehealth visits due to the increasing use of telehealth during
the public health emergency.
2019 script: N/A
2021 script:
40. In the last 6 months, were any of your visits for your own health care...
40a. In person?
40b. By phone?
40c. By video call?
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