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NTAP Application in MEARIS
Add-On Payments for New Medical Services and Technologies Paid Under the Inpatient Prospective Payment System (IPPS) (CMS-10638)
OMB: 0938-1347
IC ID: 227314
OMB.report
HHS/CMS
OMB 0938-1347
ICR 202204-0938-009
IC 227314
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1347 can be found here:
2023-09-20 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form CMS-10638
NTAP Application in MEARIS
Form
CMS-10638 New Technology Application
NTAP Application FY2024.pdf
Form
CMS-10638 New Technology Application
NTAP Application FY2024.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NTAP Application in MEARIS
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
CMS-10638
New Technology Application
NTAP Application FY2024.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
62
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
62
0
0
0
0
62
Annual IC Time Burden (Hours)
1,655
0
0
0
0
1,655
Annual IC Cost Burden (Dollars)
0
0
0
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.