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View Information Collection (IC)

[Medicaid] GenIC #26 (Revised) Child and Adult Core Set Measures CMCS
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction AQM-01 Yes Yes Fillable Fileable
Form and Instruction AQM-02 Yes Yes Fillable Fileable
Form and Instruction AQM-03 Yes Yes Fillable Fileable
Form and Instruction AQM-05 Yes Yes Fillable Fileable
Form and Instruction AQM-06 Yes Yes Fillable Fileable
Form and Instruction AQM-07 Yes Yes Fillable Fileable
Form and Instruction AQM-08 Yes Yes Fillable Fileable
Form and Instruction AQM-09 Yes Yes Fillable Fileable
Form and Instruction AQM-10 Yes Yes Fillable Fileable
Form and Instruction AQM-11 Yes Yes Fillable Fileable
Form and Instruction AQM-12 Yes Yes Fillable Fileable
Form and Instruction AQM-13 PQI 01 Yes Yes Fillable Fileable
Form and Instruction AQM-14 PQI 05 Yes Yes Fillable Fileable
Form and Instruction AQM-15 PQI 15 Yes Yes Fillable Fileable
Form and Instruction AQM-16 PQI 08 Yes Yes Fillable Fileable
Form and Instruction AQM-17 Yes Yes Fillable Fileable
Form and Instruction AQM-18 Yes Yes Fillable Fileable
Form and Instruction AQM-19 Yes Yes Fillable Fileable
Form and Instruction AQM-20 Yes Yes Fillable Fileable
Form and Instruction AQM-21 Yes Yes Fillable Fileable
Form and Instruction AQM-23 Yes Yes Fillable Fileable
Form and Instruction AQM-24 Yes Yes Fillable Fileable
Form and Instruction AQM-25 Yes Yes Fillable Fileable
Form and Instruction AQM-27 Yes Yes Fillable Fileable
Form and Instruction AQM-28 Yes Yes Fillable Fileable
Form and Instruction AQM-29 Yes Yes Fillable Fileable
Form and Instruction AQM-30 Yes Yes Fillable Fileable
Form and Instruction AQM-31 Yes Yes Fillable Fileable
Form and Instruction AQM-32 Yes Yes Fillable Fileable
Form and Instruction AQM-34 Yes Yes Fillable Fileable
Form and Instruction AQM-35 Yes Yes Fillable Fileable
Form and Instruction AQM-36 Yes Yes Fillable Fileable
Form and Instruction AQM-37 Yes Yes Fillable Fileable
Form and Instruction AQM-38 Yes Yes Fillable Fileable
Form and Instruction AQM-39 Yes Yes Fillable Fileable
Form and Instruction AQM-40 Yes Yes Fillable Fileable
Form and Instruction AQM-41 Yes Yes Fillable Fileable
Form and Instruction CQM-01 Yes Yes Fillable Fileable
Form and Instruction CQM-02 Yes Yes Fillable Fileable
Form and Instruction CQM-03 Yes Yes Fillable Fileable
Form and Instruction CQM-04 Yes Yes Fillable Fileable
Form and Instruction CQM-05 Yes Yes Fillable Fileable
Form and Instruction CQM-06 Yes Yes Fillable Fileable
Form and Instruction CQM-07 Yes Yes Fillable Fileable
Form and Instruction CQM-08 Yes Yes Fillable Fileable
Form and Instruction CQM-09 Yes Yes Fillable Fileable
Form and Instruction CQM-10 Yes Yes Fillable Fileable
Form and Instruction CQM-11 Yes Yes Fillable Fileable
Form and Instruction CQM-12 Yes Yes Fillable Fileable
Form and Instruction CQM-13 Yes Yes Fillable Fileable
Form and Instruction CQM-14 Yes Yes Fillable Fileable
Form and Instruction CQM-15 Yes Yes Fillable Fileable
Form and Instruction CQM-16 Yes Yes Fillable Fileable
Form and Instruction CQM-17 Yes Yes Fillable Fileable
Form and Instruction CQM-18 Yes Yes Fillable Fileable
Form and Instruction CQM-19 Yes Yes Fillable Fileable
Form and Instruction CQM-20 Yes Yes Fillable Fileable
Form and Instruction CQM-21 Yes Yes Fillable Fileable
Form and Instruction CQM-22 Yes Yes Fillable Fileable
Form and Instruction CQM-23 Yes Yes Fillable Fileable
Form and Instruction CQM-24 Yes Yes Fillable Fileable
Form and Instruction CQM-25 Yes Yes Fillable Fileable
Form and Instruction CQM-26 Yes Yes Fillable Fileable
Form and Instruction CQM-27 Yes Yes Fillable Fileable
Form and Instruction CQM-28 Yes Yes Fillable Fileable
Form and Instruction CQM-29 Yes Yes Fillable Fileable
Form and Instruction CQM-30 Yes Yes Fillable Fileable
Form and Instruction CQM-31 Yes Yes Fillable Fileable
Form and Instruction CQM-32 Yes Yes Fillable Fileable
Form and Instruction SQM-01A Yes Yes Fillable Fileable
Form and Instruction SQM-02A Yes Yes Fillable Fileable
Form and Instruction SQM-01C Yes Yes Fillable Fileable
Form and Instruction SQM-02C Yes Yes Fillable Fileable
Form and Instruction AQM-42 Yes Yes Fillable Fileable

Health Health Care Services

 

61,293 0
   
State, Local, and Tribal Governments
 
   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 61,431 0 61,431 0 0 0
Annual IC Time Burden (Hours) 5 0 5 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement 10/14/2026
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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