Form CMS-10838 Submissions Intercept Survey

Note: Questions will display to some users after they have uploaded a file within the QPP portal on the Quality Submissions page.

For which reporting option did you submit data? (Select all that apply)

• Traditional MIPS

• MIPS Value Pathway (MVP)

• APM Performance Pathway (APP)

How easy or difficult was it to report your PY2023 data?

• 1= Very difficult

• 2 = Somewhat difficult

• 3 = Neither easy nor difficult

• 4 = Somewhat easy

• 5 = Very easy

Did you encounter any issues while reporting PY2023 data?

1. Yes

2. No

(If the response to the first question is yes, they will receive the following query. If the answer is no, they will skip this question).

Which of the following issues did you encounter, if any? Select all that apply.

• Issue logging into the QPP portal

• Issue creating my submission file

• Issue uploading my data

• I had to contact the Help Desk about my submission.

• Other _______________

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1397 (Expiration date: 07/31/2024). The time required to complete this information collection is estimated to average .083 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. ****CMS Disclosure**** Please do not send applications, claims, payments, medical records or any documents containing sensitive information to the PRA Reports Clearance Office. Please note that any correspondence not pertaining to the information collection burden approved under the associated OMB control number listed on this form will not be reviewed, forwarded, or retained. If you have questions or concerns regarding where to submit your documents, please contact QPP at qpp@cms.hhs.gov