Quality Measures and Procedures for Hospital Reporting of Quality Data

Hospital Reporting Initiative--Hospital Quality Measures (CMS-10210)

OMB: 0938-1022

IC ID: 204350

Documents and Forms

Document Name Document Type
Form CMS-10210 Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
CMS-10210 Data Accuracy and Completeness Form 2. Hospital Quality Reporting Data Accuracy and Completeness Acknowledgement (DACA)_vFINAL(508)ff (1).pdf Form and Instruction
CMS-10210 Hospital VPB Review and Corrections Form 7. Hospital Value-Based Purchasing (VBP) Program Review and Corrections Request Form_vFINAL(508)ff.pdf Form and Instruction
CMS-10210 Extraordinary Circumstances Form 6. CMS Quality Program ECE Request Form_CY 2024_vFINAL(508)_ff.pdf Form and Instruction
CMS-10210 Hospital Compare Request Form for Withholding/Footnoting 3. Care Compare Withholding Footnoting Request Form_CY 2025_vdFINAL(508)ff.pdf Form and Instruction
CMS-10210 IQR Notice of Participation Form 1. Hospital Inpatient Quality Reporting Notice of Participation_vFINAL(508)_ff.pdf Form and Instruction
CMS-10210 IQR Reconsideration Request Form 4. CMS Quality Reporting Program APU Reconsideration Request Form_vFINAL(508)_ff.pdf Form and Instruction
CMS-10210 Validation Review for Reconsideration Request 5. CMS Hospital IQR Program Validation Review for Reconsideration Request Form_vFINAL(508)_ff.pdf Form and Instruction
CMS-10210 VBP Appeal Request Form 8. Hospital Value-Based Purchasing (VBP) Program Appeal Request Form_vFINAL(508)_ff.pdf Form and Instruction
CMS-10210 HVBP CMS Independent Review Form 9. Hospital Value-Based Purchasing (VBP) Program Independent CMS Review Request Form_vFINAL(508)_ff (1).pdf Form and Instruction
CMS-10210 Validation Educational Review Form 12. HQR_ValEdReviewForm_01_2025_vFINAL(508)ff.pdf Form and Instruction
CMS-10210 Maternal Morbidity Structural Measure 10. Maternal Morbidity Structural Measure_vFINAL(508).pdf Form and Instruction
CMS-10210 Population and Sampling 11. Population and Sampling_vFINAL(508) (1).pdf Form and Instruction
CMS-10210 Hospital Inpatient Quality Reporting Program Denominator 13. Denominator Declaration_vFINAL(508)_ (1).pdf Form and Instruction
CMS-10210 THA/TKA Patient-Reported Outcome-based Performance Measu 14. THA_TKA PRO-PM_vFINAL(508).pdf Form and Instruction
CMS-10210 Social Drivers of Health Structural Measures 15. SDOH_vFINAL(508).pdf Form and Instruction
CMS-10210 Hospital Commitment to Health Equity 16. HCHE_vFINAL(508).pdf Form and Instruction
Summary of HQR Information Collection Forms - FY2025 IPPS Final Rule - HQR PRA Package.docx Summary of Updates on HIQR Collection Forms IC Document