Information Collection Request

On-Site Inspection for Durable Medical Equipment (DME) Supplier Location and Supporting Regulations in 42 CFR, Section 424.57 (CMS-R-263)

ICR 202408-0938-034 · OMB 0938-0749 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-R-263 On-Site Inspection for Durable Medical Equipment (DME) Supplier Location and Supporting Regulations in 42 CFR, Section 424.57 Form and Instruction Modified Repair queued
CMS-R-263 60-Day Comments and CMS Responses.docx Supplementary Document Uploaded 2024-09-13 Repair queued
CMS-R-263- Supporting Statement2.docx Supporting Statement A Uploaded 2024-09-13 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8454 On-Site Inspection for Durable Medical Equipment (DME) Supplier Location and Supporting Regulations in 42 CFR, Section 424.57 Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
16,029 0
16,029 0
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
On-Site Inspection for Durable Medical Equipment (DME) Supplier Location and Supporting Regulations in 42 CFR, Section 424.57 CMS-R-263 DMEPOS Site Visit 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 16,029 0 0 0 7,774 8,255
Annual Time Burden (Hours) 16,029 0 0 0 7,774 8,255
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No