Information Collection Request

Ambulatory Surgical Center Quality Reporting Program (CMS-10530)

ICR 201911-0938-016 · OMB 0938-1270 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10530 AQ 2019-11-13- V2 Supporting Statement Part B CY2020.doc Supporting Statement B Uploaded 2019-11-26 Available
CMS-10530 AQ 2019-12-06 V3 Supporting-Statement Part A CY2020.docx Supporting Statement A Uploaded 2019-12-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214868 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2022 36 Months From Approved 01/31/2022
793,699 0 793,699
200,528 0 202,592
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
Ambulatory Surgical Center Quality Reporting (ASCQR) Program CMS-10530 Data Collection insruments

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 793,699 793,699 0 0 0 0
Annual Time Burden (Hours) 200,528 202,592 0 -2,064 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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