CY 2023 Performance Period/2025 MIPS Payment Year Burden Summary

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

OMB: 0938-1314

IC ID: 250664

Documents and Forms

Document Name Document Type
Form Appendix A CY 2023 Performance Period/2025 MIPS Payment Year Burden Summary Form and Instruction
Appendix A Self-Nomination User Guide for Qualified Clinical Data R Appendix A 2023MIPS QCDR and Registry Self-Nomination User Guide.docx Form and Instruction
Appendix A Self-Nomination User Guide for Qualified Clinical Data R Appendix A 2023MIPS QCDR and Registry Self-Nomination User Guide.docx Form and Instruction
Appendix B1 2023 Submission Form for Other Payer Requests for Other Appendix B1 2023 Payer Initiated Submission Form.pdf Form
Appendix B1 2023 Submission Form for Other Payer Requests for Other Appendix B1 2023 Payer Initiated Submission Form.pdf Form
Appendix C1 2023 Submission Form for Eligible Clinician and APM Enti Appendix C1 2023 Eligible Clinician Initiated Submission Form.docx Form and Instruction
Appendix C1 2023 Submission Form for Eligible Clinician and APM Enti Appendix C1 2023 Eligible Clinician Initiated Submission Form.docx Form and Instruction
Appendix D1 2023 Submission Form for Requests for Qualifying Alterna Appendix D1 2023 All-Payer QP Data Submission Form.docx Form and Instruction
Appendix D1 2023 Submission Form for Requests for Qualifying Alterna Appendix D1 2023 All-Payer QP Data Submission Form.docx Form and Instruction
Appendix E1 Measures under Consideration 2022 (for the 2024 performa Appendix E1 2022 MUC Data Template.docx Form and Instruction
Appendix E1 Measures under Consideration 2022 (for the 2024 performa Appendix E1 2022 MUC Data Template.docx Form and Instruction
Appendix F1 2023 Peer Reviewed Journal Article Requirement Template Appendix F1 2022 MIPS Peer-Reviewed Journal Article Requirement Template.docx Form and Instruction
Appendix F1 2023 Peer Reviewed Journal Article Requirement Template Appendix F1 2022 MIPS Peer-Reviewed Journal Article Requirement Template.docx Form and Instruction
Appendix G1 Promoting Interoperability Performance Category, 2023 Ca Appendix G1 2023 PI Call for Measures Submission Form.pdf Form and Instruction
Appendix G1 Promoting Interoperability Performance Category, 2023 Ca Appendix G1 2023 PI Call for Measures Submission Form.pdf Form and Instruction
Appendix H1 Improvement Activities Performance Category, 2023 Call f Appendix H1 2023 IA Call for Activities Submission Form.docx Form and Instruction
Appendix H1 Improvement Activities Performance Category, 2023 Call f Appendix H1 2023 IA Call for Activities Submission Form.docx Form and Instruction
Appendix I 2022 MIPS Promoting Interoperability Hardship Exception Appendix I 2022 MIPS Promoting Interoperability Hardship Exception Application Guide.pptx Form and Instruction
Appendix I 2022 MIPS Promoting Interoperability Hardship Exception Appendix I 2022 MIPS Promoting Interoperability Hardship Exception Application Guide.pptx Form and Instruction
Appendix J 2022 MIPS Extreme and Uncontrollable Circumstances Excep Appendix J 2022 Extreme and Uncontrollable Circumstances Exception Application Guide.pptx Form and Instruction
Appendix J 2022 MIPS Extreme and Uncontrollable Circumstances Excep Appendix J 2022 Extreme and Uncontrollable Circumstances Exception Application Guide.pptx Form and Instruction
Appendix K1 2023 MVP Candidates: Instructions and Template Appendix K1 2023 MVP Development Standardized Template v2.docx Form and Instruction
Appendix K1 2023 MVP Candidates: Instructions and Template Appendix K1 2023 MVP Development Standardized Template v2.docx Form and Instruction
Appendix L1 2022 Partial QP Election Form (for submission in CY 2023 Appendix L1 Partial QP Submission Form.docx Form and Instruction
Appendix L1 2022 Partial QP Election Form (for submission in CY 2023 Appendix L1 Partial QP Submission Form.docx Form and Instruction
Appendix B2 2023 Payer Initiated Submission Form Crosswalk.docx Crosswalk: Appendix B1 IC Document
Appendix B2 2023 Payer Initiated Submission Form Crosswalk.docx Crosswalk: Appendix B1 IC Document
Appendix C2 2023 Eligible Clinician Initiated Submission Form Crosswalk.docx Crosswalk: Appendix C1 IC Document
Appendix C2 2023 Eligible Clinician Initiated Submission Form Crosswalk.docx Crosswalk: Appendix C1 IC Document
Appendix D2 2023 All-Payer QP Data Submission Form Crosswalk.docx Crosswalk: Appendix D1 IC Document
Appendix D2 2023 All-Payer QP Data Submission Form Crosswalk.docx Crosswalk: Appendix D1 IC Document
Appendix E2 2022 MUC Data Template Crosswalk.docx Crosswalk: Appendix E1 IC Document
Appendix E2 2022 MUC Data Template Crosswalk.docx Crosswalk: Appendix E1 IC Document
Appendix F2 2022 MIPS Peer-Reviewed Journal Article Requirement Template Crosswalk.docx Crosswalk: Appendix F1 IC Document
Appendix F2 2022 MIPS Peer-Reviewed Journal Article Requirement Template Crosswalk.docx Crosswalk: Appendix F1 IC Document
Appendix G2 2023 PI Call for Measures Submission Form Crosswalk.docx Crosswalk: Appendix G1 IC Document
Appendix G2 2023 PI Call for Measures Submission Form Crosswalk.docx Crosswalk: Appendix G1 IC Document
Appendix H2 2023 IA Call for Activities Crosswalk.docx Crosswalk: Appendix H1 IC Document
Appendix H2 2023 IA Call for Activities Crosswalk.docx Crosswalk: Appendix H1 IC Document
Appendix K2 2023 MVP Submission Template Crosswalk.pdf Crosswalk: Appendix K1 IC Document
Appendix K2 2023 MVP Submission Template Crosswalk.pdf Crosswalk: Appendix K1 IC Document
Appendix L2 2022 Partial QP Submission Form Crosswalk.docx Crosswalk: Appendix L1 IC Document
Appendix L2 2022 Partial QP Submission Form Crosswalk.docx Crosswalk: Appendix L1 IC Document