Information Collection

Alternative NTAP Pathway

IC 262237 under ICR 202309-0938-008 · OMB 0938-1347.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1347 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.