Information Collection

Ambulatory Surgical Center Quality Reporting (ASCQR) Program

IC 214868 under ICR 201611-0938-019 · OMB 0938-1270.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1270 can be found here:

Documents and Forms

Document Name Document Type
CMS-10530.ASC Manual_v6 0a_Full (with Exp and Control No).pdf Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CMS-10530.ASC Manual_v6 0a_Full (with Exp and Control No).pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,260	Number of Respondents for Small Entity: 0

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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,407,576	662,760	744,816
Annual IC Time Burden (Hours)	367,711	-77,079	444,790
Annual IC Cost Burden (Dollars)	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.