Information Collection

CY 2026 Performance Period/2028 MIPS Payment Year

IC 271014 under ICR 202605-0938-004 · OMB 0938-1314.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form Appendix A
2026 MIPS QCDR and Registry Self-nomination User Guide CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix B
2026 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
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) CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix D
2026 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix E
Measures under Consideration 2025 Data Template for Candidate Measures CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix F
2025 Peer Reviewed Journal Article Requirement Template CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix G
Improvement Activities Performance Category, 2026 Call for Activities Submission Form CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix H
2025 MIPS Promoting Interoperability Hardship Exception Application Guide CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix I
2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix J
2025 MVP Candidates: Instructions and Template CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix K
2025 Partial QP Election Form (for submission in CY 2026) CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Form Appendix L
2025 MVP Registration Form CY 2026 Performance Period/2028 MIPS Payment Year
Form and Instruction
Appendix A 2026 MIPS QCDR and Registry Self-nomination User Guide
Appendix A 2026 MIPS QCDR Registry Self-Nomination User Guide.pdf
Form and Instruction
Appendix B 2026 Submission Form for Other Payer Requests for Other
Appendix B 2026 Payer Initiated Submission Form.pdf
Form and Instruction
Appendix C 2026 Submission Form for Eligible Clinician and APM Enti
Appendix C 2026 Eligible Clinician Initiated Submission Form.pdf
Form and Instruction
Appendix D 2026 Submission Form for Requests for Qualifying Alterna
Appendix D 2026 Requests for QP Determinations under the All-Payer Comb.pdf
Form and Instruction
Appendix E Measures under Consideration 2025 Data Template for Cand
Appendix E MUC 2025 Data Template for Candidate Measures.pdf
Form and Instruction
Appendix F 2025 Peer Reviewed Journal Article Requirement Template
Appendix F 2025 MIPS Peer Reviewed Journal Article Requirement Template.pdf
Form and Instruction
Appendix G Improvement Activities Performance Category, 2026 Call f
Appendix G IA Performance Category 2026 Call for Activities Submission Form.pdf
Form and Instruction
Appendix H 2025 MIPS Promoting Interoperability Hardship Exception
Appendix H 2025 PI Hardship Exception Application Guide.pdf
Form and Instruction
Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Excep
Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide.pdf
Form and Instruction
Appendix J 2025 MVP Candidates: Instructions and Template
Appendix J 2026 MVP Development Standardized Template.pdf
Form and Instruction
Appendix K 2025 Partial QP Election Form (for submission in CY 2026
Appendix K 2025 Partial QP Election Form (for submission in CY 2026).pdf
Form and Instruction
Appendix L 2025 MVP Registration Form
Appendix L 2025 MVP Registration Guide.pdf
Form and Instruction
Appendix A 2026 MIPS QCDR and Registry Self-nomination User Guide Crosswalk.pdf
CROSSWALK Appendix A
IC Document
Appendix B 2026 Submission Form for Other Payer Requests Crosswalk.pdf
CROSSWALK Appendix B
IC Document
Appendix C 2026 Submission Form for Eligible Clinician Requests Crosswalk.pdf
CROSSWALK Appendix C
IC Document
Appendix D 2026 Submission Form for Requests for QP Determination Crosswalk.pdf
CROSSWALK Appendix D
IC Document
Appendix E MUC 2025 Data Template for Candidate Measures Crosswalk.pdf
CROSSWALK Appendix E
IC Document
Appendix F 2025 Peer Reviewed Journal Article Requirement Crosswalk.pdf
CROSSWALK Appendix F
IC Document
Appendix G Improvement Activities Performance Category 2026 Call for Activities Submission Form Crosswalk.pdf
CROSSWALK Appendix G
IC Document
Appendix H 2025 Promoting Interoperability Hardship Exception Crosswalk.pdf
CROSSWALK Appendix H
IC Document
Appendix I 2025 EandU Circumstances Exception App Guide Crosswalk.pdf
CROSSWALK Appendix I
IC Document
Appendix J 2026 MVP Submission Template Crosswalk.pdf
CROSSWALK Appendix J
IC Document
Appendix K 2025 2025 Partial QP Election Form Crosswalk.pdf
CROSSWALK Appendix K
IC Document
Appendix L 2025 MVP Registration Form Crosswalk.pdf
CROSSWALK Appendix L
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Appendix A Yes Yes Fillable Fileable
Form and Instruction Appendix B Yes Yes Fillable Fileable
Form and Instruction Appendix C Yes Yes Fillable Fileable
Form and Instruction Appendix D Yes Yes Fillable Fileable
Form and Instruction Appendix E Yes Yes Fillable Fileable
Form and Instruction Appendix F Yes Yes Fillable Fileable
Form and Instruction Appendix G Yes Yes Fillable Fileable
Form and Instruction Appendix H Yes Yes Fillable Fileable
Form and Instruction Appendix I Yes Yes Fillable Fileable
Form and Instruction Appendix J Yes Yes Fillable Fileable
Form and Instruction Appendix K Yes Yes Fillable Fileable
Form and Instruction Appendix L Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 141,690 0 5,706 0 0 135,984
Annual IC Time Burden (Hours) 591,156 0 -58,215 0 0 649,371
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
CROSSWALK Appendix A 05/11/2026
CROSSWALK Appendix B 05/11/2026
CROSSWALK Appendix C 05/11/2026
CROSSWALK Appendix D 05/11/2026
CROSSWALK Appendix E 05/11/2026
CROSSWALK Appendix F 05/11/2026
CROSSWALK Appendix G 05/11/2026
CROSSWALK Appendix H 05/11/2026
CROSSWALK Appendix I 05/11/2026
CROSSWALK Appendix J 05/11/2026
CROSSWALK Appendix K 05/11/2026
CROSSWALK Appendix L 05/11/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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