QPP/MIPS Post Webinar Presentation Satisfaction Survey (CMS-10862)

Quality Payment Program/Merit-Based Incentive Payment System (MIPS) Surveys and Feedback Collections (CMS-10695)

Documents and Forms

Document Name Document Type
Form CMS-10862 QPP/MIPS Post Webinar Presentation Satisfaction Survey (CMS-10862) Form and Instruction
CMS-10862 QPP/MIPS Post Webinar Presentation Satisfaction Survey CMS-10862 QPP MIPS Post Webinar Presentation Satisfaction Survey.docx Form and Instruction

Information Collection (IC) Details

IC Title:	QPP/MIPS Post Webinar Presentation Satisfaction Survey (CMS-10862)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10862	QPP/MIPS Post Webinar Presentation Satisfaction Survey	CMS-10862 QPP MIPS Post Webinar Presentation Satisfaction Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	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.