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Appendix L1 2022 Partial QP Election Form (for submission in CY 2023
Quality Payment Program (QPP)/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
Appendix L1 Partial QP Submission Form
OMB: 0938-1314
OMB.report
HHS/CMS
OMB 0938-1314
ICR 202307-0938-005
IC 250664
Appendix L1 2022 Partial QP Election Form (for submission in CY 2023
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1314 can be found here:
2024-09-19 - Revision of a currently approved collection
2023-11-17 - Revision of a currently approved collection
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