OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202509-0938-009 · OMB 0938-1314 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form Appendix L 2025 MVP Registration Form Form and Instruction New Available
Form Appendix K 2025 Partial QP Election Form (for submission in CY 2026) Form and Instruction New Available
Form Appendix J 2025 MVP Candidates: Instructions and Template Form and Instruction New Available
Form Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide Form and Instruction New Available
Form Appendix H 2025 MIPS Promoting Interoperability Hardship Exception Application Guide Form and Instruction New Available
Form Appendix G Improvement Activities Performance Category, 2026 Call for Activities Submission Form Form and Instruction New Available
Form Appendix F 2025 Peer Reviewed Journal Article Requirement Template Form and Instruction New Available
Form Appendix E Measures under Consideration 2025 Data Template for Candidate Measures Form and Instruction New Available
Form Appendix D 2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option Form and Instruction New Available
Form Appendix C 2026 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form) Form and Instruction New Available
Form Appendix B 2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) Form and Instruction New Available
Form Appendix A 2026 MIPS QCDR and Registry Self-nomination User Guide Form and Instruction New Available
Form Appendix A 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New Repair queued
Form Appendix L 2025 MVP Registration Form Form and Instruction Modified Repair queued
Form Appendix K 2025 Partial QP Election Form (for submission in CY 2026) Form and Instruction Modified Repair queued
Form Appendix J 2025 MVP Candidates: Instructions and Template Form and Instruction Modified Repair queued
Form Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide Form and Instruction Modified Repair queued
Form Appendix H 2025 MIPS Promoting Interoperability Hardship Exception Application Guide Form and Instruction Modified Repair queued
Form Appendix G Improvement Activities Performance Category, 2026 Call for Activities Submission Form Form and Instruction Modified Available
Form Appendix F 2025 Peer Reviewed Journal Article Requirement Template Form and Instruction Modified Repair queued
Form Appendix E Measures under Consideration 2025 Data Template for Candidate Measures Form and Instruction Modified Repair queued
Form Appendix D 2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option Form and Instruction Modified Repair queued
Form Appendix C 2026 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form) Form and Instruction Modified Repair queued
Form Appendix B 2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) Form and Instruction Modified Repair queued
Form Appendix A 2026 MIPS QCDR and Registry Self-nomination User Guide Form and Instruction Modified Repair queued
Form Appendix A CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified Repair queued
CMS-10621_Supporting_Statement_B_(CMS-1832-P_version 1)_508.docx Supporting Statement B Uploaded 2025-09-05 Available
CMS-10621_Supporting_Statement_B_(CMS-1832-P_version 1)_508.docx Supporting Statement B Uploaded 2025-09-05 Repair queued
CMS-10621_Supporting_Statement_A_(CMS-1832-P_version 3)_508 CLEAN.docx Supporting Statement A Uploaded 2025-09-05 Repair queued
CMS-10621_Supporting_Statement_A_(CMS-1832-P_version 3)_508 CLEAN.docx Supporting Statement A Uploaded 2025-09-05 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2025 MVP Registration Form
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2025 Partial QP Election Form (for submission in CY 2026)
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2025 MVP Candidates: Instructions and Template
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2025 MIPS Promoting Interoperability Hardship Exception Application Guide
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction NewImprovement Activities Performance Category, 2026 Call for Activities Submission Form
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2025 Peer Reviewed Journal Article Requirement Template
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction NewMeasures under Consideration 2025 Data Template for Candidate Measures
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2026 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form)
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form)
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New2026 MIPS QCDR and Registry Self-nomination User Guide
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction New
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2025 MVP Registration Form
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2025 Partial QP Election Form (for submission in CY 2026)
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2025 MVP Candidates: Instructions and Template
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2025 MIPS Promoting Interoperability Hardship Exception Application Guide
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction ModifiedImprovement Activities Performance Category, 2026 Call for Activities Submission Form
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2025 Peer Reviewed Journal Article Requirement Template
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction ModifiedMeasures under Consideration 2025 Data Template for Candidate Measures
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2026 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form)
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form)
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified2026 MIPS QCDR and Registry Self-nomination User Guide
271014 CY 2026 Performance Period/2028 MIPS Payment Year Form and Instruction Modified
ICR Details
0938-1314 202509-0938-009
Historical Inactive 202412-0938-008
HHS/CMS CCSQ
Quality Payment Program (QPP)/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
Revision of a currently approved collection   No
Regular
Comment filed on proposed rule and continue 11/26/2025
Retrieve Notice of Action (NOA) 09/09/2025
In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments.
  Inventory as of this Action Requested Previously Approved
02/28/2027 36 Months From Approved 02/28/2027
135,984 0 135,984
649,371 0 649,371
0 0 0
Section 1848(q) of the Social Security Act, as amended by section 101 of the Medicare Access and CHIP Reauthorization Act of 2015, authorizes the establishment of a Merit-based Incentive Payment System (MIPS) for eligible clinicians. Beginning in CY 2017, eligible clinicians are required to collect and submit data on four performance categories to CMS (quality, cost, advancing care information and improvement activities). This program replaces and consolidates portions of the PQRS, Value-based Modifier, and the Medicare EHR Incentive Program. The Act also establishes a second track, Advanced Alternative Payment Models (APMs) for clinicians to participate in instead of MIPS.
US Code: 42 USC 1395w-4 Name of Law: Medicare Access and CHIP Reauthorization Act of 2014
  
US Code: 42 USC 1395w-4 Name of Law: Medicare Access and CHIP Reauthorization Act of 2014
0938-AV50 Proposed rulemaking 90 FR 32352 07/16/2025
  90 FR 32352 07/16/2025
No
2
IC Title Form No. Form Name
2027 Performance Period/2029 MIPS Payment Year Appendix I, Appendix J, Appendix L, Appendix G, Appendix K, Appendix E, Appendix A, Appendix B, Appendix C, Appendix D, Appendix F, Appendix H 2026 MIPS QCDR and Registry Self-nomination User Guide ,   2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) ,   2026 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form) ,   2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option ,   Measures under Consideration 2025 Data Template for Candidate Measures ,   2025 Peer Reviewed Journal Article Requirement Template ,   Improvement Activities Performance Category, 2026 Call for Activities Submission Form ,   2025 MIPS Promoting Interoperability Hardship Exception Application Guide ,   2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide ,   2025 MVP Candidates: Instructions and Template ,   2025 Partial QP Election Form (for submission in CY 2026) ,   2025 MVP Registration Form
CY 2026 Performance Period/2028 MIPS Payment Year Appendix A, Appendix B, Appendix C, Appendix D, Appendix F, Appendix H, Appendix I, Appendix J, Appendix L, Appendix G, Appendix K, Appendix E 2026 MIPS QCDR and Registry Self-nomination User Guide ,   2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) ,   2026 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form) ,   2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option ,   Measures under Consideration 2025 Data Template for Candidate Measures ,   2025 Peer Reviewed Journal Article Requirement Template ,   Improvement Activities Performance Category, 2026 Call for Activities Submission Form ,   2025 MIPS Promoting Interoperability Hardship Exception Application Guide ,   2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide ,   2025 MVP Candidates: Instructions and Template ,   2025 Partial QP Election Form (for submission in CY 2026) ,   2025 MVP Registration Form
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Overall, this iteration proposes to adjust the current estimates for the CY 2026 performance period/2028 MIPS payment year by plus 5,706 responses and minus 58,216 hours. Additionally, we propose adjusting the estimates for the CY 2027 performance period/2029 MIPS payment year by plus 1,733 hours. See Table series 34 of this Supporting Statement for a summary of this iteration’s rule and non-rule related changes for each ICR. We have also revised Appendices A through L. See section 12 of this Supporting Statement for additional details.
$392
Yes Part B of Supporting Statement
    Yes
    Yes
No
No
No
No
Mitch Bryman 410 786-5258 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/09/2025