Information Collection

2021 > (Quality Performance Category) Registration and Enrollment for CMS Web Interface (see SS-A Table 14)

IC 227505 under ICR 202111-0938-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Appendix N1 2020 CMS WI and CAHPS Registration Guide.pdf	Instruction
Appendix N1 2020 CMS WI and CAHPS Registration Guide.pdf	Instruction
Appendix N2 2021 CMS Web Interface and CAHPS for MIPS Registration Guide Crosswalk.pdf Crosswalk - 2021 CMS Web Interface and CAHPS for MIPS Registration	IC Document
Appendix N2 2021 CMS Web Interface and CAHPS for MIPS Registration Guide Crosswalk.pdf Crosswalk - 2021 CMS Web Interface and CAHPS for MIPS Registration	IC Document

IC Title:

2021 > (Quality Performance Category) Registration and Enrollment for CMS Web Interface (see SS-A Table 14)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 414.1330 and 414.1335

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
Instruction			Appendix N1 2020 CMS WI and CAHPS Registration Guide.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: 90

Number of Respondents for Small Entity: 69

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-90	90
Annual IC Time Burden (Hours)	-23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Crosswalk - 2021 CMS Web Interface and CAHPS for MIPS Registration	Appendix N2 2021 CMS Web Interface and CAHPS for MIPS Registration Guide Crosswalk.pdf	01/05/2021

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