Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2021 > (Quality Performance Category) CMS Web Interface Submission Type (see SS-A Table 13) Removed 0 0 0
2021 > (Quality Performance Category) Registration and Enrollment for CMS Web Interface (see SS-A Table 14) Removed 0 0 0 Instruction
2022 >> (Improvement Activities Performance Category) Data Submission (see SS-A Table 25) Modified 81562 6797 0
2022 >> (Improvement Activities Performance Category) Nomination of Improvement Activities (see SS-A Table 27) Modified 31 136 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 23) Modified 10 5 0 Form and Instruction CMS-10621 Promoting Interoperability Performance Category, 2022 Call for Measures Submission Form
2022 >> (PI Performance Category) Data Submission (see SS-A Table 21) Modified 51647 138930 0
2022 >> (PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 19) Modified 42827 10707 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 33) Modified 38 10 0
2022 >> (Quality Performance Category) Call for Quality Measures (see SS-A Table 18) Modified 28 154 0 Form and Instruction CMS-10621 Peer Reviewed Journal Article Requirement Template
Form and Instruction CMS-10621 Measures under Consideration 2021, Data Template for Candidate Measures
2022 >> (Quality Performance Category) Claims Collection Type (see Table SS-A 10) Modified 28252 401178 0
2022 >> (Quality Performance Category) QCDR/MIPS CQM Collection Type (see SS-A Table 11) Modified 52036 472643 0
2022 >> (Quality Performance Category) eCQM Collection Type (see SS-A Table 12) Modified 48573 388584 0
2022 >> Group Registration for CMS Web Interface (SS-A Table 17) New 90 23 0
2022 >> Nomination of MVPs (SS-A Table 28) Modified 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) Modified 15 15 0
2022 >> Other Payer Advanced APM Identification: Clinician Initiated Process (see SS-A Table 31) Modified 15 150 0 Form CMS-10621 Appendix E1 2022 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Fo
2022 >> Other Payer Advanced APM Identification: Payer Initiated Process (see SS-A Table 30) Modified 15 150 0 Form and Instruction CMS-10621 2022 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form)
2022 >> Partial Qualifying APM Participant (QP) Election (see SS-A Table 29) Modified 250 63 0 Form and Instruction CMS-10621 Partial QP Election Form
2022 >> QPP Identity Management Application Process (see SS-A Table 9) Unchanged 3741 3741 0
2022 >> Quality Data Submission via the CMS Web Interface (SS-A Table 16) New 114 7030 0 Form and Instruction CMS-10621 2021 CMS Web Interface and CAHPS for MIPS Registration Guide
2022 >> Self-nomination: QCDR and Qualified Registry (see SS-A Tables 3 and 4) Modified 300 2402 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 32) 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
2023 > (Improvement Activities Performance Category) Data Submission (see SS-A Table 26) Modified 81582 6771 0
2023 > (Improvement Activities Performance Category) Nomination of Improvement Activities (see SS-A Table 27) Modified 31 136 0 Form CMS-10621 Improvement Activities Performance Category, 2021 Call for Activities Submission Form
2023 > (PI Performance Category) Call for Promoting Interoperability Measures (see SS-A Table 23) Modified 10 5 0 Form and Instruction CMS-10621 Promoting Interoperability Performance Category, 2021 Call for Measures Submission Form
2023 > (PI Performance Category) Data Submission (see SS-A Table 22) Modified 51667 138984 0
2023 > (PI Performance Category) Reweighting Applications for Promoting Interoperability and Other Performance Categories (see SS-A Table 19) Modified 42827 10707 0 Form CMS-10621 Hardship Exception Application Form
Form CMS-10621 Extreme and Uncontrollable Circumstances Application Form
2023 > (Physician Compare) Opt Out for Voluntary Participants (see SS-A Table 33) Modified 38 10 0
2023 > (Quality Performance Category) Call for Quality Measures (see SS-A Table 18) 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
2023 > (Quality Performance Category) Claims Collection Type (see Table SS-A 10) Modified 25427 361063 0
2023 > (Quality Performance Category) QCDR/MIPS CQM Collection Type (see SS-A Table 11) Modified 46890 425902 0
2023 > (Quality Performance Category) eCQM Collection Type (see SS-A Table 12) Modified 43773 350184 0
2023 > MVP Quality Submission: 2023 Performance Period (SS-A Table 15) New 12917 83673 0
2023 > MVP Registration: 2023 Performance Period (SS-A Table 13) New 12918 3230 0
2023 > Nomination of MVPs (SS-A Table 28) Modified 25 300 0 Form and Instruction CMS-10621 Stakeholder Submissions of MIPS Value Pathways (MVP) Candidates: Instructions and Template
2023 > Open Authorization Credentialing and Token Request Process (SS-A Table 5) Modified 15 15 0
2023 > Other Payer Advanced APM Identification: Clinician Initiated Process (see SS-A Table 31) Modified 15 150 0 Form CMS-10621 Eligible Clinician Initiated Submission Form
2023 > Other Payer Advanced APM Identification: Payer Initiated Process (see SS-A Table 30) Modified 15 150 0 Form and Instruction CMS-10621 Payer Initiated Submission Form
2023 > Partial Qualifying APM Participant (QP) Election (see SS-A Table 29) Modified 250 63 0
2023 > QPP Identity Management Application Process (see SS-A Table 9) Modified 3741 3741 0
2023 > Self-nomination: QCDR and Qualified Registry (see SS-A Tables 3 and 4) Modified 300 2402 0 Instruction
Instruction
Form CMS-10621 2021 Qualified Clinical Data Registry (QCDR) Measure Submission Template
2023 > Subgroup Registration: 2023 Performance Period (SS-A Table 14) New 20 10 0
2023 > Submission of Data for All-Payer QP Determinations under the All-Payer Combination Option (see SS-A Table 32) 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
Total burden requested under this ICR: 633160 2826178 0  
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