Information Collection

2022 >> (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 23)

IC 245883 under ICR 202107-0938-013 · OMB 0938-1314.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1314 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10621 (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 23)	Form and Instruction
CMS-10621 Promoting Interoperability Performance Category, 2022 Ca Appendix I1 2022 PI Call for Measures Submission Form.pdf	Form and Instruction
CMS-10621 Promoting Interoperability Performance Category, 2022 Ca Appendix I1 2022 PI Call for Measures Submission Form.pdf	Form and Instruction
Appendix I2 2022 PI Call for Measures Submission Form Crosswalk.pdf CROSSWALK: Promoting Interoperability Performance Category, 2022 Call for Measures Submission Form	IC Document
Appendix I2 2022 PI Call for Measures Submission Form Crosswalk.pdf CROSSWALK: Promoting Interoperability Performance Category, 2022 Call for Measures Submission Form	IC Document

IC Title:

2022 >> (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 23)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 414.1375

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10621	Promoting Interoperability Performance Category, 2022 Call for Measures Submission Form	Appendix I1 2022 PI Call for Measures Submission Form.pdf		Yes	Yes	Fillable Fileable

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: 10

Number of Respondents for Small Entity: 10

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CROSSWALK: Promoting Interoperability Performance Category, 2022 Call for Measures Submission Form	Appendix I2 2022 PI Call for Measures Submission Form Crosswalk.pdf	09/01/2021

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