OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202605-0938-004 · OMB 0938-1314 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide Form and Instruction Modified Available
Form Appendix K 2025 Partial QP Election Form (for submission in CY 2026) Form and Instruction Modified Available
Form Appendix H 2025 Promoting Interoperability Hardship Exception Application Guide Form and Instruction Modified Available
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 Available
Form Appendix J 2026 MVP Candidates: Instructions and Template Form and Instruction Modified Available
Form Appendix E Measures under Consideration 2025 Data Template for Candidate Measures Form and Instruction Modified Available
Form Appendix L 2025 MVP Registration Guide Form and Instruction Modified 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 Modified 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 Modified 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 Modified Available
Form Appendix A 2026 MIPS QCDR and Registry Self-nomination User Guide Form and Instruction Modified Available
Form Appendix L 2025 MVP Registration Form Form and Instruction Modified Available
Form Appendix K 2025 Partial QP Election Form (for submission in CY 2026) Form and Instruction Modified Available
Form Appendix J 2025 MVP Candidates: Instructions and Template Form and Instruction Modified Available
Form Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide Form and Instruction Modified Available
Form Appendix H 2025 MIPS Promoting Interoperability Hardship Exception Application Guide Form and Instruction Modified Available
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 Available
Form Appendix E Measures under Consideration 2025 Data Template for Candidate Measures Form and Instruction Modified 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 Modified 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 Modified 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 Modified Available
Form Appendix A 2026 MIPS QCDR and Registry Self-nomination User Guide Form and Instruction Modified Available
CMS-10621_Supporting_Statement_B _(CMS-1832-F version 2).docx Supporting Statement B Uploaded 2026-05-11 Available
CMS-10621_Supporting_Statement_A_(CMS-1832-F version 5).docx Supporting Statement A Uploaded 2026-05-11 Available
IC Document Collections
IC IDCollectionTypeStatusForm
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction Modified2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction Modified2025 Partial QP Election Form (for submission in CY 2026)
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction Modified2025 Promoting Interoperability Hardship Exception Application Guide
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction ModifiedImprovement Activities Performance Category, 2026 Call for Activities Submission Form
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction Modified2025 Peer Reviewed Journal Article Requirement Template
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction Modified2026 MVP Candidates: Instructions and Template
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction ModifiedMeasures under Consideration 2025 Data Template for Candidate Measures
277412 2027 Performance Period/2029 MIPS Payment Year Form and Instruction Modified2025 MVP Registration Guide
277412 2027 Performance Period/2029 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
277412 2027 Performance Period/2029 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)
277412 2027 Performance Period/2029 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)
277412 2027 Performance Period/2029 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 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
ICR Details
0938-1314 202605-0938-004
Received in OIRA 202509-0938-009
HHS/CMS CCSQ
Quality Payment Program (QPP)/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
Revision of a currently approved collection   No
Regular 05/12/2026
  Requested Previously Approved
36 Months From Approved 02/28/2027
283,380 135,984
1,184,045 649,371
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 Final or interim final rulemaking 90 FR 49266 11/05/2025
  90 FR 32352 07/16/2025
90 FR 49266 11/05/2025
No
2
IC Title Form No. Form Name
2027 Performance Period/2029 MIPS Payment Year Appendix G, Appendix H, Appendix I, Appendix J, Appendix K, Appendix L, Appendix A, Appendix B, Appendix C, Appendix D, Appendix E, Appendix F 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 ,   2025 MVP Registration Guide ,   Measures under Consideration 2025 Data Template for Candidate Measures ,   2026 MVP Candidates: Instructions and Template ,   2025 Peer Reviewed Journal Article Requirement Template ,   Improvement Activities Performance Category, 2026 Call for Activities Submission Form ,   2025 Promoting Interoperability Hardship Exception Application Guide ,   2025 Partial QP Election Form (for submission in CY 2026) ,   2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide
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
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 283,380 135,984 0 147,396 0 0
Annual Time Burden (Hours) 1,184,045 649,371 1,733 532,941 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The changes are associated with our November 5, 2025 (90 FR 49266) CY 2026 PFS final rule (CMS-1832-F; RIN 0938-AV50) and adjustments to the currently approved burden as a result of updated data sources and assumptions. We have also revised Appendices A through L.
$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.
05/12/2026