Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2021 > (Improvement Activities Performance Category) Data Submission (see SS-A Table 21) Modified 79927 6661 0
2021 > (Improvement Activities Performance Category) Nomination of Improvement Activities (see SS-A Table 22) Modified 31 93 0 Form CMS-10621 Improvement Activities Performance Category, 2021 Call for Activities Submission Form
2021 > (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 19) Modified 10 5 0 Form and Instruction CMS-10621 Promoting Interoperability Performance Category, 2021 Call for Measures Submission Form
2021 > (PI Performance Category) Data Submission (see SS-A Table 18) Modified 53636 143208 0
2021 > (PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 16) Modified 52099 13025 0 Form CMS-10621 Hardship Exception Application Form
Form CMS-10621 Extreme and Uncontrollable Circumstances Application Form
2021 > (Physician Compare) Opt Out for Voluntary Participants (see SS-A Table 28) Modified 3486 872 0
2021 > (Quality Performance Category) CMS Web Interface Submission Type (see SS-A Table 13) Modified 111 6845 0
2021 > (Quality Performance Category) Call for Quality Measures (see SS-A Table 15) Modified 28 154 0 Form and Instruction CMS-10621 Peer Reviewed Journal Article Requirement Template
Form and Instruction CMS-10621 Measures under Consideration 2019, Data Template for Candidate Measures
2021 > (Quality Performance Category) Claims Collection Type (see Table SS-A 10) Modified 29273 415677 0
2021 > (Quality Performance Category) QCDR/MIPS CQM Collection Type (see SS-A Table 11) Modified 52899 480482 0
2021 > (Quality Performance Category) Registration and Enrollment for CMS Web Interface (see SS-A Table 14) Modified 90 23 0 Instruction
2021 > (Quality Performance Category) eCQM Collection Type (see SS-A Table 12) Modified 50409 403272 0
2021 > Nomination of MVPs (SS-A Table 23) New 25 300 0 Form and Instruction CMS-10621 Stakeholder Submissions of MIPS Value Pathways (MVP) Candidates: Instructions and Template
2021 > Open Authorization Credentialing and Token Request Process (SS-A Table 5) New 15 15 0
2021 > Other Payer Advanced APM Identification: Clinician Initiated Process (see SS-A Table 26) Modified 150 1500 0 Form CMS-10621 Eligible Clinician Initiated Submission Form
2021 > Other Payer Advanced APM Identification: Payer Initiated Process (see SS-A Table 25) Modified 80 800 0 Form and Instruction CMS-10621 Payer Initiated Submission Form
2021 > Partial Qualifying APM Participant (QP) Election (see SS-A Table 24) Modified 300 75 0
2021 > QPP Identity Management Application Process (see SS-A Table 9) Modified 3741 3741 0
2021 > Self-nomination: QCDR and Qualified Registry (see SS-A Tables 3 and 4) Modified 265 1965 0 Instruction
Instruction
Form CMS-10621 2021 Qualified Clinical Data Registry (QCDR) Measure Submission Template
2021 > Submission of Data for All-Payer QP Determinations under the All-Payer Combination Option (see SS-A Table 27) Modified 551 2755 0 Form CMS-10621 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option
2022 >> (Improvement Activities Performance Category) Data Submission (see SS-A Table 21) New 79927 6661 0
2022 >> (Improvement Activities Performance Category) Nomination of Improvement Activities (see SS-A Table 22) New 31 93 0 Form CMS-10621 Improvement Activities Performance Category, 2021 Call for Activities Submission Form
2022 >> (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 19) New 10 5 0 Form and Instruction CMS-10621 Promoting Interoperability Performance Category, 2021 Call for Measures Submission Form
2022 >> (PI Performance Category) Data Submission (see SS-A Table 18) New 53636 143208 0
2022 >> (PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 16) New 52099 13025 0 Form CMS-10621 Hardship Exception Application Form
Form CMS-10621 Extreme and Uncontrollable Circumstances Application Form
2022 >> (Physician Compare) Opt Out for Voluntary Participants (see SS-A Table 28) New 3486 872 0
2022 >> (Quality Performance Category) Call for Quality Measures (see SS-A Table 15) New 28 154 0 Form and Instruction CMS-10621 Peer Reviewed Journal Article Requirement Template
Form and Instruction CMS-10621 Measures under Consideration 2019, Data Template for Candidate Measures
2022 >> (Quality Performance Category) Claims Collection Type (see Table SS-A 10) New 29273 415677 0
2022 >> (Quality Performance Category) QCDR/MIPS CQM Collection Type (see SS-A Table 11) New 52944 480890 0
2022 >> (Quality Performance Category) eCQM Collection Type (see SS-A Table 12) New 50475 403800 0
2022 >> Nomination of MVPs (SS-A Table 23) New 25 300 0 Form and Instruction CMS-10621 Stakeholder Submissions of MIPS Value Pathways (MVP) Candidates: Instructions and Template
2022 >> Open Authorization Credentialing and Token Request Process (SS-A Table 5) New 15 15 0
2022 >> Other Payer Advanced APM Identification: Clinician Initiated Process (see SS-A Table 26) New 150 1500 0 Form CMS-10621 Eligible Clinician Initiated Submission Form
2022 >> Other Payer Advanced APM Identification: Payer Initiated Process (see SS-A Table 25) New 80 800 0 Form and Instruction CMS-10621 Payer Initiated Submission Form
2022 >> Partial Qualifying APM Participant (QP) Election (see SS-A Table 24) New 300 75 0
2022 >> QPP Identity Management Application Process (see SS-A Table 9) New 3741 3741 0
2022 >> Self-nomination: QCDR and Qualified Registry (see SS-A Tables 3 and 4) New 265 1965 0 Instruction
Instruction
Form CMS-10621 2021 Qualified Clinical Data Registry (QCDR) Measure Submission Template
2022 >> Submission of Data for All-Payer QP Determinations under the All-Payer Combination Option (see SS-A Table 27) New 551 2755 0 Form CMS-10621 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option
Total burden requested under this ICR: 654162 2957004 0  
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