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

View Information Collection (IC)

CY 2025 Performance Period/2027 MIPS Payment Year
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Appendix A Yes Yes Fillable Fileable
Form and Instruction Appendix B Yes Yes Fillable Fileable
Form and Instruction Appendix C Yes Yes Fillable Fileable
Form and Instruction Appendix D 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 G Yes Yes Fillable Fileable
Form and Instruction Appendix H Yes Yes Fillable Fileable
Form and Instruction Appendix I Yes Yes Fillable Fileable
Form and Instruction Appendix J Yes Yes Fillable Fileable
Form and Instruction Appendix K Yes Yes Fillable Fileable
Form and Instruction Appendix L Yes Yes Fillable Fileable

Health Health Care Services

 

135,984 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 135,984 2,506 0 133,478 0 0
Annual IC Time Burden (Hours) 649,371 -7,570 0 656,941 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CROSSWALK Appendix A: 2025 MIPS QCDR and Registry Self-nomination User Guide 12/11/2024
CROSSWALK Appendix B: 2025 Submission Form for Other Payer Requests for Other Payer Advanced Alternative Payment Model Determinations (Payer Initiated Submission Form) 12/11/2024
CROSSWALK Appendix C : 2025 Submission Form for Eligible Clinician and APM Entity Requests for Other Payer Advanced Alternative Payment Model Determinations (Eligible Clinician Initiated Submissio 12/11/2024
CROSSWALK Appendix D: 2025 Submission Form for Requests for Qualifying Alternative Payment Model Participant (QP) Determinations under the All-Payer Combination Option 12/11/2024
CROSSWALK Appendix E: Measures under Consideration 2024 Data Template for Candidate Measures 12/11/2024
CROSSWALK Appendix F: 2024 Peer Reviewed Journal Article Requirement Template 12/11/2024
CROSSWALK Appendix G: Improvement Activities Performance Category, 2025 Call for Activities Submission Form 12/11/2024
CROSSWALK Appendix H: 2024 MIPS Promoting Interoperability Hardship Exception Application Guide 12/11/2024
CROSSWALK Appendix I: 2024 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide 12/11/2024
CROSSWALK Appendix J: 2025 MVP Candidates: Instructions and Template 12/11/2024
CROSSWALK Appendix K: 2024 Partial QP Election Form (for submission in CY 2025 12/11/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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