View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

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

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Appendix A1 Yes Yes Fillable Fileable
Form Appendix B1 Yes Yes Fillable Fileable
Form and Instruction Appendix C1 Yes Yes Fillable Fileable
Form and Instruction Appendix D1 Yes Yes Fillable Fileable
Form and Instruction Appendix E Yes Yes Fillable Fileable
Form and Instruction Appendix F Yes Yes Fillable Fileable
Form and Instruction Appendix G1 Yes Yes Fillable Fileable
Form and Instruction Appendix H1 Yes Yes Fillable Fileable
Form and Instruction Appendix I1 Yes Yes Fillable Fileable
Form and Instruction Appendix J1 Yes Yes Fillable Fileable
Form and Instruction Appendix K1 Yes Yes Fillable Fileable
Form and Instruction Appendix L 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 0 0 0 -191,225 0 191,225
Annual IC Time Burden (Hours) 0 0 0 -728,142 0 728,142
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk: Appendix A1 11/16/2023
Crosswalk: Appendix B1 11/16/2023
Crosswalk: Appendix C1 11/16/2023
Crosswalk: Appendix D1 11/16/2023
Crosswalk: Appendix G1 11/16/2023
Crosswalk: Appendix H1 11/16/2023
Crosswalk: Appendix I1 11/16/2023
Crosswalk: Appendix J1 11/16/2023
Crosswalk: Appendix K1 11/16/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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