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414.1400 (Quality Performance Category) CAPHs for MIPS
(CMS-10621) Merit-based Incentive Payment System
OMB: 0938-1314
IC ID: 224260
OMB.report
HHS/CMS
OMB 0938-1314
ICR 201611-0938-002
IC 224260
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1314 can be found here:
2024-09-19 - Revision of a currently approved collection
2023-11-17 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
414.1400 (Quality Performance Category) CAPHs for MIPS
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
42 CFR 414.1400
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
132,307
Number of Respondents for Small Entity:
132,307
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
132,307
0
132,307
0
0
0
Annual IC Time Burden (Hours)
43,661
0
43,661
0
0
0
Annual IC Cost Burden (Dollars)
0
0
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.