Alternative NTAP Pathway

Add-On Payments for New Medical Services and Technologies Paid Under the Inpatient Prospective Payment System (IPPS) (CMS-10638)

Documents and Forms

Document Name Document Type
Form CMS-10638 Alternative NTAP Pathway Form
CMS-10638 New Technology Application NTAP Application for PRA Revision_FY2025 30d updated clean.pdf Form
CMS-10638 New Technology Application NTAP Application for PRA Revision_FY2025 30d updated clean.pdf Form
FY_2018_New_Technology_Application.docx IC Document
FY_2018_New_Technology_Application.docx IC Document

Information Collection (IC) Details

IC Title:	Alternative NTAP Pathway	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 for PRA Revision_FY2025 30d updated clean.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	375	375
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
	FY_2018_New_Technology_Application.docx	06/28/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.