Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
$414.1430 (Partial Qualifying APM Participant (QP) election) Modified 81 20 0
414.1330 (Quality Performance Category) Call for Measures Modified 140 630 0 Form and Instruction CMS-10621 Data Template for Candidate Measures
Instruction
414.1375 Advancing Care Information Performance Category - Call for Measures Modified 47 24 0 Form and Instruction CMS-10621 ACI Call for Measures Submission Form
Form and Instruction CMS-10621 Promoting Interoperability Performance Category (Call for Measures Submission Form)
Instruction
414.1445 Other Payer Advanced APM Determininations: Medicaid Specific Clinician Initiated Process Modified 150 1500 0
§414.1325 and 414.1335 CMS Quality Payment Program Identity Management Application Process New 3741 3741 0
§414.1330 and §414.1335 CMS Web Interface Submission Mechanism Modified 286 16931 0 Instruction
§414.1330 and §414.1335 Claims Submission Mechanism Modified 274702 3900768 0
§414.1330 and §414.1335 EHR Submission Mechanism Modified 53529 428232 0
§414.1330 and §414.1335 Qualified Registry or QCDR Submission Mechanism Modified 107056 972390 0
§414.1330 and §414.1335 Quality Performance Category) Registration and Enrollment for CMS Web Interface Modified 67 17 0
§414.1360 (Improvement Activities Performance Category) Call for Activities Modified 125 250 0 Form CMS-10621 Improvement Activities Performance Category (Call for Activities Submission Form)
§414.1360 (Improvement Activities) Modified 392938 32745 0
§414.1375 (Advancing Care Information Performance Category) Modified 67622 180325 0
§414.1375 (Advancing Care Information Performance Category) Significant Hardships, including for small practices and decertification of EHRs Modified 87211 21803 0
§414.1395 (Physician Compare) Opt Out for Voluntary Participants Modified 10433 2608 0
§414.1400 QCDR and qualified registry self nomination Modified 350 2850 0
§414.1440 Other Payer Advanced APM Identification: Other Payer Initiated Process Modified 165 1650 0 Form and Instruction CMS-10621 Clinician Initiated Submission Form
Form and Instruction CMS-10621 Payer Initiated Submission Form
§414.1440 Submission of Data for All-Payer QP Determinations under the All-Payer Combination Option New 92 460 0
Total burden requested under this ICR: 998735 5566944 0  
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