OMB control number
Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652)
OMB 0938-1343 · HHS/CMS.
OMB 0938-1343
Abstract (2000 characters maximum) Section 1848(q)(5)(I) of the Social Security Act (hereafter the Act) as amended by MACRA provides for the use of voluntary virtual groups for certain assessment purposes, including the election of individual MIPS eligible clinicians (solo practitioners) and groups with 10 or fewer eligible clinicians to join or form a virtual group and the requirements under the election process.
The latest form for Virtual Groups for Merit-Based Incentive Payment System (MIPS) (CMS-10652) expires 2027-04-30 and is listed under ICR 202401-0938-010.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-10652 MIPS: Virtual Group Election Process | Form and Instruction |
 CMS-10652 VG for MIPS Supporting Statement A 9-13-23.docx | Supporting Statement A |
 MIPS: Virtual Group Election Process |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202401-0938-010 | Extension without change of a currently approved collection | 2024-01-24 | Approved without change | |
| 202005-0938-002 | Revision of a currently approved collection | 2020-05-07 | ||
| 201708-0938-026 | New collection (Request for a new OMB Control Number) | 2017-08-31 | Approved with change |