CMS-2728 Form Clarification

CMS-2728 Form Clarification

August 10 2023

End Stage Renal Disease (ESRD) Quality Reporting System (EQRS) users should continue to use the CMS-2728 Form in EQRS.

The Centers for Medicare and Medicaid Services (CMS) is in the process of proposing updates to the CMS-2728 Form. At this time, none of the updates have been approved or finalized. The use of any CMS-2728 Form other than what is available in EQRS is not authorized until otherwise instructed.

Communication on any finalized updates and/or changes to the CMS-2728 Form will be forthcoming from CMS.

If you are having technical issues with accessing the EQRS user interface, please contact the Center for Clinical Standards and Quality (CCSQ) Service Center. The CCSQ Service Center is open Monday-Friday 8 a.m. to 8 p.m. Eastern Time and can be reached via phone at (866) 288-8912, email at or by going to CCSQ Support Center.