Information Collection Request
Quality Payment Program (QPP)/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
ICR 202301-0938-017 · OMB 0938-1314 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1314 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form Appendix A CY 2023 Performance Period/2025 MIPS Payment Year Burden Summary |
Form and Instruction | Modified | Repair queued |
 CMS-10621 - Supporting Statement A (CMS-1770-F Version 2).docx |
Supporting Statement A | Uploaded 2023-01-25 | Repair queued |
| Comment Response Document.docx |
Supplementary Document | Uploaded 2023-01-25 | Repair queued |
| CMS-10621-Supporting Statement B (CMS-1770-F)Version1_clean[1].docx |
Supporting Statement B | Uploaded 2023-01-25 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 250664 |  CY 2023 Performance Period/2025 MIPS Payment Year Burden Summary |
Form and Instruction | Modified | |
| 250662 | CY 2022 Performance Period/2024 MIPS Payment Year Burden Summary |
Other-Appendix A1 (See Table 3): 2022 Qualified Registry Fact Sh | Removed |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1314 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202111-0938-001 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |