Information Collection Request

Hospital Outpatient Quality Reporting (OQR) Program (CMS-10250)

ICR 202412-0938-020 · OMB 0938-1109 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 CMS.10250.Extraordinary Circumstances Exemption Request Form Form and Instruction Modified Repair queued
Form CMS-10250 CMS-10250.HOQR ProgramValidationReconForm Form and Instruction Modified Available
Form CMS-10250.OQR_With CMS-10250.OQR_Withdraw Form Form and Instruction Modified Repair queued
Form CMS-10250 Web Based Data Collection Tool Form and Instruction Modified Available
Form CMS-10250 Hospital Outpatient Quality Reporting Form and Instruction Modified Available
CMS-10250.HOQR CY 2025 Supporting Statement Part B (final rule).docx Supporting Statement B Uploaded 2025-01-10 Available
CMS-10250.HOQR CY 2025 Supporting Statement Part B (final rule).docx Supporting Statement B Uploaded 2025-01-10 Available
HOQR CY 2025 Supporting Statement Part A (final rule).docx Supporting Statement A Uploaded 2025-01-06 Repair queued
HOQR CY 2025 Supporting Statement Part A (final rule).docx Supporting Statement A Uploaded 2025-01-06 Missing upstream

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS.10250.Extraordinary Circumstances Exemption Request Form
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS-10250.HOQR ProgramValidationReconForm
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS-10250.OQR_Withdraw Form
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedWeb Based Data Collection Tool
217995 Hospital Outpatient Quality Reporting Form and Instruction Modified
217995 Hospital Outpatient Quality Reporting Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2026 36 Months From Approved 11/30/2026
40,960,000 0 968,150
15,184,997 0 276,148
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Hospital Outpatient Quality Reporting CMS-10250.OQR_Withdraw Form, CMS-10250, CMS-10250, CMS-10250 ,   ,   ,  

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 40,960,000 968,150 0 39,991,850 0 0
Annual Time Burden (Hours) 15,184,997 276,148 0 14,908,849 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No