Information Collection Request

Ambulatory Surgical Center (ASC) Covered Procedure List (CPL) Pre-Proposed Rule Recommendation Request (CMS-10809)

ICR 202308-0938-013 · OMB 0938-1458 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10809 MEARIS Screenshots Form and Instruction New Available
Form CMS-10809 ASC CPL Pre-Proposed Rule Recommendation Request Form and Instruction New Available
Form CMS-10809 Procedure Nominations Form and Instruction New Repair queued
CMS-10809 Supporting Statement A.docx Supporting Statement A Uploaded 2023-08-23 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
261757 Procedure Nominations Form and Instruction NewMEARIS Screenshots
261757 Procedure Nominations Form and Instruction NewASC CPL Pre-Proposed Rule Recommendation Request
261757 Procedure Nominations Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2027 36 Months From Approved
100 0 0
50 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Procedure Nominations CMS-10809, CMS-10809 ,  

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 0 0 0 0 100
Annual Time Burden (Hours) 50 0 0 0 0 50
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No