Information Collection Request

Ambulatory Surgical Center Quality Reporting Program (CMS-10530)

ICR 202212-0938-010 · OMB 0938-1270 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10530 Data Collection insruments Form and Instruction Modified Available
Form CMS-10530 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction Modified Repair queued
CMS-10530.SupportingStatementPartB.docx Supporting Statement B Uploaded 2022-12-08 Repair queued
CMS-10530.SupportingStatementPartA.docx Supporting Statement A Uploaded 2022-12-08 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214868 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction ModifiedData Collection insruments
214868 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction Modified
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
08/31/2025 36 Months From Approved 08/31/2025
1,189,376 0 1,189,376
303,538 0 303,538
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Ambulatory Surgical Center Quality Reporting (ASCQR) Program CMS-10530



Reginfo record details
  No