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

Forms and supporting documents for this ICR
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

Information collection document groups
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

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 02/28/2027
283,380 135,984
1,184,045 649,371
0 0
Reginfo record details
2
table that charts list of burden
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 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
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 ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
table that charts list of burden
  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
Reginfo record details
  No