Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process

Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process (CMS-10224)

OMB: 0938-1042

IC ID: 183056

Information Collection (IC) Details

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Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process
 
No Modified
 
Voluntary
 
42 CFR 414.40 45 CFR 162.10002

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10224 HCPCS Application CMS-10224_2020_HCPCS_Application_FINAL_112619.pdf Yes No Fillable Fileable
Other-Screenshot 20190809 Qualtrics Screenshots.docx Yes Yes Fillable Fileable

Health Health Care Services

 

150 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 150 0 0 50 0 100
Annual IC Time Burden (Hours) 1,500 0 -150 550 0 1,100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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