OMB control number
Quality Payment Program (QPP)/Merit-Based Incentive Payment System (MIPS) (CMS-10621)
OMB 0938-1314 · HHS/CMS.
OMB 0938-1314
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.
The latest form for Quality Payment Program (QPP)/Merit-Based Incentive Payment System (MIPS) (CMS-10621) expires 2027-02-28 and is listed under ICR 202412-0938-008.
Latest Forms, Documents, and Supporting Material
Form Appendix I 2025 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide
CMS-10621_Supporting_Statement_B _(CMS-1832-F version 2).docx
2027 Performance Period/2029 MIPS Payment YearAll Historical Document Collections
OMB Details
CY 2024 Performance Period/2026 MIPS Payment Year Burden Summary
Federal Enterprise Architecture: Health - Health Care Services
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form Appendix G1 | Improvement Activities Performance Category, 2024 Call for Activities Submission Form | Fillable Fileable | Form and instruction |
| Form Appendix F | 2023 Peer Reviewed Journal Article Requirement Template | Fillable Fileable | Form and instruction |
| Form Appendix E | Measures under Consideration 2023 Data Template for Candidate Measures | Fillable Fileable | Form and instruction |
| Form Appendix D1 | 2024 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option | Fillable Fileable | Form and instruction |
| Form Appendix B1 | 2024 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) | Fillable Fileable | Form |
| Form Appendix A1 | 2024 MIPS QCDR and Registry Self-nomination User Guide | Fillable Fileable | Form and instruction |
| Form Appendix J1 | 2024 MVP Candidates: Instructions and Template | Fillable Fileable | Form and instruction |
| Form Appendix C1 | 2024 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form) | Fillable Fileable | Form and instruction |
| Form Appendix L | 2023 MVP Registration Form | Fillable Fileable | Form and instruction |
| Form Appendix K1 | 2023 Partial QP Election Form | Fillable Fileable | Form and instruction |
| Form Appendix H1 | 2023 MIPS Promoting Interoperability Hardship Exception Application Guide | Fillable Fileable | Form and instruction |
| Form Appendix I1 | 2023 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.