Information Collection Request

Ambulatory Surgical Center Quality Reporting Program (CMS-10530)

ICR 202309-0938-003 · OMB 0938-1270 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10530 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction Modified Repair queued
CMS-10530. ASCQR CY 2024 FR Supporting Statement B (proposed rule).docx Supporting Statement B Uploaded 2023-09-06 Repair queued
CMS-10530. ASCQR CY 2024 FR Supporting Statement A (proposed rule).docx Supporting Statement A Uploaded 2023-09-06 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
214868 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 08/31/2025
1,294,592 1,189,376
58,060 51,158
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.CMS Quality Program ECE Request Form_CY , CMS-10530.ASCQR_Withdraw Form, CMS-10530 Data Collection insruments ,   CMS-10530.CMS Quality Program ECE Request Form_CY 2024_vFinal ,   CMS-10530.ASCQR_Withdraw Form

table that charts list of burden
  Total Request 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 1,294,592 1,189,376 0 105,216 0 0
Annual Time Burden (Hours) 58,060 51,158 0 6,902 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No