Appendix D 2026 Submission Form for Requests for Qualifying Alterna

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

Appendix D 2026 Requests for QP Determinations under the All-Payer Comb

2027 Performance Period/2029 MIPS Payment Year

OMB: 0938-1314