CROSSWALK Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Pa

Appendix F2 2022 All-Payer QP Data Submission Form Crosswalk.pdf

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

CROSSWALK Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Pa

OMB: 0938-1314

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Download: pdf | pdf
All-Payer QP Data Submission Form

CY 2021 Final versus CY 2022 Proposed

Burden impact: The changes to this form reflect proposals in the CY2022 Physician Fee
Schedule (PFS) Proposed Rule for the Quality Payment Program. There are no impacts to
burden as a result of these changes.
*****
Change #1:
Location: Page 1, Line 33
Reason for Change:
2021 Threshold changed through statute.
CY 2021 Final Rule text:
75
CY 2022 Proposed Rule text:
50
*****
Change #2:
Location: Page 1, Line 33
Reason for Change:
2022 Threshold changed through statute.
CY 2021 Final Rule text:
75
CY 2022 Proposed Rule text:
50
*****
Change #3:
Location: Page 1, Line 34
Reason for Change:
Threshold changed to reflect statute.
CY 2021 Final Rule text:
40
CY 2022 Proposed Rule text:
50
*****
Change #4:
Location: Page 2, Line 6
Reason for Change:
2021 Threshold changed through statute.
CY 2021 Final Rule text:
50
CY 2022 Proposed Rule text:
35

*****
Change #5:
Location: Page 2, Line 6
Reason for Change:
2022 Threshold changed through statute.
CY 2021 Final Rule text:
50
CY 2022 Proposed Rule text:
35
*****
Change #6:
Location: Page 2, Line 7
Reason for Change:
2022 Partial QP Patient Count Threshold changed through statute.
CY 2021 Final Rule text:
35.
CY 2022 Proposed Rule text:
25
*****
Change #7:
Location: Page 4, Line 26
Reason for Change:
Year updated.
CY 2021 Final Rule text:
2019
CY 2022 Proposed Rule text:
2022
*****
Change #8:
Location: Page 4, Line 26
Reason for Change:
Year updated.
CY 2021 Final Rule text:
Note: Only participants in the Medicare Shared Savings Program may submit data at the
TIN level for performance year 2019.
CY 2022 Proposed Rule text:
*****
Change #9:
Location: Page 6, Line 7
Reason for Change:
Year updated.
CY 2021 Final Rule text:
2021

CY 2022 Proposed Rule text:
2022
*****
Change #10:
Location: Page 6, Line 28
Reason for Change:
Year updated.
CY 2021 Final Rule text:
January 1, 2021-June 30, 2021
CY 2022 Proposed Rule text:
January 1, 2022-June 30, 2022
*****
Change #11:
Location: Page 7, Line 26
Reason for Change:
Year updated.
CY 2021 Final Rule text:
January 1, 2021-June 30, 2021
CY 2022 Proposed Rule text:
January 1, 2022-June 30, 2022
*****
Change #12:
Location: Page 7, Line 42
Reason for Change:
Year updated.
CY 2021 Final Rule text:
January 1, 2021-June 30, 2021
CY 2022 Proposed Rule text:
January 1, 2022-June 30, 2022


File Typeapplication/pdf
File TitleAll-Payer QP Data Submission Form Crosswalk: CY 2021 Final versus CY 2022 Proposed
AuthorCMS
File Modified2021-07-11
File Created2021-07-11

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