Archive of Previous Paper Tools

Claims-Based Measures

Resource materials pertaining to past ISR confidential review periods for the CBMs are listed below:

Checklists

The following checklists were designed to assist IPFs with meeting prior submission deadlines:

Optional Paper Tools

Previous Transition Record Paper Tools

Paper Tools for Data Submitted Summer of 2021

FY 2022 Paper Tools.ZIP

Paper Tools for Data Submitted Summer of 2020

FY2021 Paper Tools.ZIP

Paper Tools for Data Submitted Summer of 2019

HBIPS-2 and -3
HBIPS-5
Screening for Metabolic Disorders
SUB-1, -2/2a, -3/3a
Tobacco Use (TOB)-1, -2/-2a, -3/-3a
- (Q1-Q2 2018)
- (Q3-Q4 2018)
Transition Record with Specified Elements Received by Discharged Patients and Timely Transmission of Transition Record
IMM-2 (Q4 2018 through Q1 2019)
Non-Measure Data Collection

Paper Tools for Data Submitted Summer of 2018

Paper Tools for Data Submitted Summer of 2017

UPDATED:Hospital-Based Inpatient Psychiatric Services (HBIPS)-2 and -3
HBIPS-5
- Q1-Q2 2016
- Q3-Q4 2016
Immunization (IMM)-2
Substance Use (SUB)-1, -2/-2a
Tobacco Use (TOB)-1,-2/-2a, -3/-3a
- Q1-Q2 2016
- Q3-Q4 2016
Non-Measure Data Collection Tool