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CY 2024 Performance Period/2026 MIPS Payment Year Burden Summary
 
No Modified
 
Mandatory
 
42 CFR 414.1335 42 CFR 414.1380 42 CFR 414.1440 42 CFR 414.1360 42 CFR 414.1430 42 CFR 414.1400 42 CFR 414.1325 42 CFR 414.1375 42 CFR 414.1445 42 CFR 414.1395

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Appendix A1 2024 MIPS QCDR and Registry Self-nomination User Guide Appendix A1 2024 MIPS QCDR Registry Self-Nomination User Guide.pdf Yes Yes Fillable Fileable
Form Appendix B1 2024 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) Appendix B1 2024 Payer Initiated Submission Form.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix C1 2024 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submission Form) Appendix C1 2024 Eligible Clinician Initiated Submission Form.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix D1 2024 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option Appendix D1 2024 All-Payer QP Data Submission Form.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix E Measures under Consideration 2023 Data Template for Candidate Measures Appendix E 2023 MUC Data Template.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix F 2023 Peer Reviewed Journal Article Requirement Template Appendix F 2023 MIPS Peer-Reviewed Journal Article Requirement Template.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix G1 Improvement Activities Performance Category, 2024 Call for Activities Submission Form Appendix G1 2024 IA Call for Activities Submission Form.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix H1 2023 MIPS Promoting Interoperability Hardship Exception Application Guide Appendix H1 2023 MIPS Promoting Interoperability Hardship Exception Application Guide.pptx Yes Yes Fillable Fileable
Form and Instruction Appendix I1 2023 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide Appendix I1 2023 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide .pdf Yes Yes Fillable Fileable
Form and Instruction Appendix J1 2024 MVP Candidates: Instructions and Template Appendix J1 2024 MVP Development Standardized Template.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix K1 2023 Partial QP Election Form Appendix K1 Partial QP Submission Form.pdf Yes Yes Fillable Fileable
Form and Instruction Appendix L 2023 MVP Registration Form Appendix L MVP Registration Form.xlsx Yes Yes Fillable Fileable

Health Health Care Services

 

191,225 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 191,225 1,365 0 30,332 0 159,528
Annual IC Time Burden (Hours) 728,142 -4,147 0 18,429 0 713,860
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk: Appendix A1 Appendix A2 2024 MIPS QCDR and Registry Self-Nomination User Guide Crosswalk.pdf 11/16/2023
Crosswalk: Appendix B1 Appendix B2 2024 Payer Initiated Submission Form Crosswalk.pdf 11/16/2023
Crosswalk: Appendix C1 Appendix C2 2024 Eligible Clinician Initiated Submission Form Crosswalk.pdf 11/16/2023
Crosswalk: Appendix D1 Appendix D2 2024 All-Payer QP Data Submission Form Crosswalk.pdf 11/16/2023
Crosswalk: Appendix G1 Appendix G2 2024 IA Call for Activities Crosswalk.pdf 11/16/2023
Crosswalk: Appendix H1 Appendix H2 2023 MIPS Promoting Interoperability Hardship Exception Application Guide Crosswalk.pdf 11/16/2023
Crosswalk: Appendix I1 Appendix I2 2023 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide Crosswalk .pdf 11/16/2023
Crosswalk: Appendix J1 Appendix J2 2024 MVP Submission Template Crosswalk.pdf 11/16/2023
Crosswalk: Appendix K1 Appendix K2 Partial QP Submission Form Crosswalk.pdf 11/16/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.