Document Name Document Type
Form CMS-10210 Data Accuracy and Completeness Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Hospital VPB Review and Corrections Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Extraordinary Circumstances Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Hospital Compare Request Form for Withholding/Footnoting Data for Public Reporting Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 IQR Notice of Participation Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 IQR Reconsideration Request Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Validation Review for Reconsideration Request Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 VBP Appeal Request Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 HVBP CMS Independent Review Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Validation Educational Review Form Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Maternal Morbidity Structural Measure Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Population and Sampling Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Hospital Inpatient Quality Reporting Program Denominator Declaration Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 THA/TKA Patient-Reported Outcome-based Performance Measure Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
Form CMS-10210 Age Friendly Structural Measure Quality Measures and Procedures for Hospital Reporting of Quality Data Form and Instruction
CMS-10210 Data Accuracy and Completeness Form 02. Hospital Quality Reporting Data Accuracy and Completeness Acknowledgement (DACA).pdf Form and Instruction
CMS-10210 Hospital VPB Review and Corrections Form 13. Hospital Value-Based Purchasing (VBP) Program Review and Corrections Request Form.pdf Form and Instruction
CMS-10210 Extraordinary Circumstances Form 06. CMS Quality Program ECE Request Form_CY 2027.pdf Form and Instruction
CMS-10210 Hospital Compare Request Form for Withholding/Footnoting 03. Care Compare Withholding Footnoting Request Form_CY 2027.pdf Form and Instruction
CMS-10210 IQR Notice of Participation Form 01. Hospital Inpatient Quality Reporting Notice of Participation.pdf Form and Instruction
CMS-10210 IQR Reconsideration Request Form 04. CMS Quality Reporting Program APU Reconsideration Request Form.pdf Form and Instruction
CMS-10210 Validation Review for Reconsideration Request 05. CMS Hospital IQR Program Validation Review for Reconsideration Request Form.pdf Form and Instruction
CMS-10210 VBP Appeal Request Form 14. Hospital Value-Based Purchasing (VBP) Program Appeal Request Form.pdf Form and Instruction
CMS-10210 HVBP CMS Independent Review Form 15. Hospital Value-Based Purchasing (VBP) Program Independent CMS Review Request Form.pdf Form and Instruction
CMS-10210 Validation Educational Review Form 09. HQR_Val Ed Review Form.pdf Form and Instruction
CMS-10210 Maternal Morbidity Structural Measure 07. Maternal Morbidity Structural Measure.pdf Form and Instruction
CMS-10210 Population and Sampling 08. Population and Sampling.pdf Form and Instruction
CMS-10210 Hospital Inpatient Quality Reporting Program Denominator 10. Denominator Declaration.pdf Form and Instruction
CMS-10210 THA/TKA Patient-Reported Outcome-based Performance Measu 11. THA_TKA PRO-PM.pdf Form and Instruction
CMS-10210 Age Friendly Structural Measure 12. Age Friendly Structural Measure.pdf Form and Instruction
00. Summary of HQR Information Collection Forms - FY2027 IPPS Final Rule_508 (1).pdf Summary of Updates on Hospital Quality Reporting Information Collection Forms IC Document

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