Registry or Qualified Clinical Data Registry Vendors (QCDR) (Reporting on Behalf of Eligible Professionals and/or Group Practices)

Physician Quality Reporting System (PQRS) (CMS-10276)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1059 can be found here:

Documents and Forms

Document Name Document Type
2015_PQRS_ImplementationGuide.pdf Instruction
2015_PQRS_MAV_ProcessforRegistryBasedReporting_01152015.pdf Instruction

Information Collection (IC) Details

IC Title:	Registry or Qualified Clinical Data Registry Vendors (QCDR) (Reporting on Behalf of Eligible Professionals and/or Group Practices)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 414.90 42 CFR 414.92

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2015_PQRS_MAV_ProcessforRegistryBasedReporting_01152015.pdf		Yes	Yes	Printable Only
Instruction			2015_PQRS_ImplementationGuide.pdf		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Performance Measurement and Reporting System	FR Citation: 72 FR 52133

Number of Respondents: 150	Number of Respondents for Small Entity: 50

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	150	100	0	50
Annual IC Time Burden (Hours)	1,500	0	1,000	500
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.