Information Collection Request

Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432)

ICR 202304-0938-013 · OMB 0938-1171 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10432 Notice of Participation Form and Instruction Modified Available
Form CMS-10432 IPF Screenshots (see Supporting Statement A, section 12,under the list of Information Collection Instruments and Instruction/Guidance Documents) Form and Instruction Modified Available
Form CMS-10432 Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program Form and Instruction Modified Repair queued
CMS-10432 - Supporting Statement A (CMS-1783-P version 6).docx Supporting Statement A Uploaded 2023-07-06 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
202349 Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program Form and Instruction ModifiedNotice of Participation
202349 Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program Form and Instruction ModifiedIPF Screenshots (see Supporting Statement A, section 12,under the list of Information Collection Instruments and Instruction/Guidance Documents)
202349 Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program Form and 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
12,366,112 0 12,366,112
3,093,162 0 3,093,162
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program CMS-10432, CMS-10432 ,  



Reginfo record details
  No