Information Collection Request
Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)
ICR 202401-0938-011 · OMB 0938-1222 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1222 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10450 CAHPS for MIPS Group Registration |
Form and Instruction | Modified | Repair queued |
| Form CMS-10450 CAHPS for MIPS Survey Vendor Application |
Form and Instruction | Modified | Repair queued |
| Form CMS-10450 CAHPS for MIPS Survey Beneficiary Participation |
Form | Modified | Repair queued |
 CMS-10450-Supporting-Statement-B-FINAL.docx |
Supporting Statement B | Uploaded 2024-02-13 | Repair queued |
| CMS-10450-Supporting-Statement-A-2-13-24.docx |
Supporting Statement A | Uploaded 2024-02-13 | Repair queued |
| Appendix G Technical References.docx |
Supplementary Document | Uploaded 2018-12-13 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 227777 |  CAHPS for MIPS Group Registration |
Form and Instruction | Modified | |
| 227776 | CAHPS for MIPS Survey Vendor Application |
Form and Instruction | Modified | |
| 206234 | CAHPS for MIPS Survey Beneficiary Participation |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1222 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202107-0938-012 |
| Agency Tracking No | CCSQ |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |