Ambulatory Surgical Center Quality Reporting Program (CMS-10530)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10530 Centers for Medicare & Medicaid Services (CMS) Quality Program Extraordinary Circumstances Exceptions (ECE) Request Form	Form and Instruction	Modified	Repair queued
Form CMS-10530.ASCQR_Wi CMS-10530.ASCQR_Withdraw Form	Form and Instruction	Modified	Repair queued
Form CMS-10530 Data Collection insruments	Form and Instruction	Modified	Repair queued
Form CMS-10530 Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Form and Instruction	Modified	Repair queued
ASCQR CY 2025 Supporting Statement Part B (final rule).docx	Supporting Statement B	Uploaded 2025-01-10	Available
ASCQR CY 2025 Supporting Statement Part B (final rule).docx	Supporting Statement B	Uploaded 2025-01-10	Repair queued
ASCQR CY 2025 Supporting Statement Part A (final rule).docx	Supporting Statement A	Uploaded 2025-01-06	Repair queued
ASCQR CY 2025 Supporting Statement Part A (final rule).docx	Supporting Statement A	Uploaded 2025-01-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214868	Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Form and Instruction	Modified	Centers for Medicare & Medicaid Services (CMS) Quality Program Extraordinary Circumstances Exceptions (ECE) Request Form
214868	Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Form and Instruction	Modified	CMS-10530.ASCQR_Withdraw Form
214868	Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Form and Instruction	Modified	Data Collection insruments
214868	Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Form and Instruction	Modified
214868	Ambulatory Surgical Center Quality Reporting (ASCQR) Program	Instruction	Modified

ICR Details

OMB Control No: 0938-1270	ICR Reference No: 202412-0938-019
Status: Historical Active	Previous ICR Reference No: 202410-0938-016
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Ambulatory Surgical Center Quality Reporting Program (CMS-10530)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/29/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/10/2025
Terms of Clearance: Prior to the re-submission of the information collection (IC), CMS is requirement to revise its quality data reporting discussion in the supporting statement A and burden estimate based on any quality measurement changes in the 2026 and 2027 Medicare payment rulemaking cycle.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2026	36 Months From Approved	07/31/2027
Responses	80,102,500	0	1,294,592
Time Burden (Hours)	618,519	0	54,491
Cost Burden (Dollars)	0	0	0

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Abstract: Section 109(a) of the Tax Relief and Health Care Act of 2006 (TRHCA) (Pub. L. 109-432) amended section 1833(t) of the Social Security Act by adding a new subsection (17) that affects the payment rate update applicable to Outpatient Prospective Payment System (OPPS) payments for services furnished by hospitals in outpatient settings on or after January 1, 2009. Section 1833(t)(17)(A) of the Social Security Act, which applies to hospitals as defined under section 1886(d)(1)(B) of the Social Security Act, requires that hospitals that fail to report data required for quality measures selected by the Secretary in the form and manner required by the Secretary under section 1833(t)(17)(B) of the Social Security Act will incur a reduction in their annual payment update (APU) factor to the hospital outpatient department fee schedule by 2.0 percentage points. Hospital OQR Program payment determinations are made based on Hospital OQR Program quality measure data reported and supporting forms submitted by hospitals as specified through rulemaking. To reduce burden, a variety of different data collection mechanisms are employed, with every consideration taken to employ existing data and data collection systems.

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Authorizing Statute(s): PL: Pub.L. 109 - 432 109(b) Name of Law: Tax Relief and Health Care Act of 2006
   US Code: 42 USC 1395 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV35	Final or interim final rulemaking	89 FR 93912	11/27/2024

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Ambulatory Surgical Center Quality Reporting (ASCQR) Program	CMS-10530.ASCQR_Withdraw Form, CMS-10530, CMS-10530	Data Collection insruments ,   CMS-10530.ASCQR_Withdraw Form ,   Centers for Medicare & Medicaid Services (CMS) Quality Program Extraordinary Circumstances Exceptions (ECE) Request Form

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ICR Summary of Burden

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	80,102,500	1,294,592	0	78,807,908	0	0
Annual Time Burden (Hours)	618,519	54,491	0	564,028	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The adoption of the FCHE measure will result in a total estimated burden increase of 746 hours at a cost of $41,313 beginning with the CY 2027 payment determination. The adoption of the Screening for SDOH and Screen Positive Rate for SDOH measures will result in a total estimated burden increase of 711,479 hours at a cost of $17,447,164 and 746 hours at a cost of $41,313, respectively, when mandatory reporting begins for the CY 2028 payment determination. The updated average number of cases reported per ASC for the Unplanned Anterior Vitrectomy measure will result in an estimated decrease of 12,279 hours at a cost of $680,011. Accounting for the impact of the finalized measure adoptions in the CY 2025 OPPS/ASC final rule and updated burden estimates, our updated estimate of the number of ASCs results in an annual burden decrease of 3,901 hours and $216,021 through the CY 2030 payment determination. The aggregate increase from the CY 2027 payment determination through the CY 2030 payment determination due to these finalized measure adoptions and adjustments is 696,791 hours (-3,901 + 746 + 711,479 + 746 – 12,279) and $16,633,758 (-$216,021 + $41,313 + $17,447,164 + $41,313 - $680,011) as shown in Tables 5 and 6 for the CY 2027 through CY 2030 payment determinations.

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Annual Cost to Federal Government: $10,255,377

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/10/2025

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