Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
$414.1430 (Partial Qualifying APM Participant (QP) election) New 543 272 0
§414.1330 and §414.1335 CMS Web Interface Submission Mechanism New 652 52460 0 Form and Instruction CMS-10621 List of Quality Performance Category Measures
§414.1330 and §414.1335 Claims Submission Mechanism New 299169 5325208 0 Form and Instruction CMS-10621 List of Quality Performance Category Measures
§414.1330 and §414.1335 EHR Submission Mechanism New 77241 849651 0 Form and Instruction CMS-10621 List of Quality Performance Category Measures
§414.1330 and §414.1335 Qualified Registry or QCDR Submission Mechanism New 214590 2163711 0 Form and Instruction CMS-10621 List of Quality Performance Category Measures
§414.1360 (CPIA) New 676325 2028975 0 Form and Instruction CMS-10621 Proposed CPIA Inventory
§414.1375 (Advancing Care Information Performance Category) New 517425 2069700 0 Form and Instruction CMS-10621 List of Advancing Care Information Performance Category
§414.1390 (Data Validation and Auditing) New 430 645 0 Form and Instruction CMS-10621 MIPS Data Validation Survey Respondent Communication
Form and Instruction CMS-10621 MIPS Data Validation Electronic Survey
§414.1400 QCDR and qualified registry self nomination New 150 1500 0 Form and Instruction CMS-10621 QCDR Self-nomination form
Total burden requested under this ICR: 1786525 12492122 0  
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