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

HCPCS Modification to Code Set Form (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 MEARIS HCPCS Level II Application Screenshots. MEARIS HCPCS Level II Application Screenshots.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

150 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 0 0 150
Annual IC Time Burden (Hours) 1,500 0 0 0 0 1,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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