CAHPS for MIPS Group Registration

Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey for the Merit-Based Incentive Payment System (MIPS) (CMS-10450)

Documents and Forms

Document Name Document Type
Form CMS-10450 CAHPS for MIPS Group Registration Form and Instruction
CMS-10450 CAHPS Registration Guide Appendix-A1-CAHPS-Registration-Guide.pdf Form and Instruction
CMS-10450 CAHPS Registration Guide Appendix-A1-CAHPS-Registration-Guide.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	CAHPS for MIPS Group Registration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 414.1330 and 414.1335

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10450	CAHPS Registration Guide	Appendix-A1-CAHPS-Registration-Guide.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 266	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	266	-16	282
Annual IC Time Burden (Hours)	200	-12	212
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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