Information Collection Request

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

ICR 202601-0938-005 · OMB 0938-1109 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 CMS Quality Reporting Program APU Reconsideration Request Form Form and Instruction Modified Available
Form CMS-10250 CMS.10250.Extraordinary Circumstances Exemption Request Form Form and Instruction Modified Available
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 Available
Form CMS-10250 Web Based Data Collection Tool Form and Instruction Modified Available
CMS-10250_HOQR CY 2026 FR Supporting Statement Part A_.docx Supporting Statement A Uploaded 2026-01-12 Available
CMS-10250_HOQR CY 2026 FR Supporting Statement Part B_.docx Supporting Statement B Uploaded 2026-01-12 Available
CMS-10250 HOQR CY 2026 FR response to public comments .docx Supplementary Document Uploaded 2026-01-12 Available
CY 2026 FR HOQR Reg Text Crosswalk_CLEAN.docx Supplementary Document Uploaded 2026-01-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217995 Hospital Outpatient Quality Reporting Form and Instruction ModifiedCMS Quality Reporting Program APU Reconsideration Request Form
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 Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 04/30/2026
12,800 40,960,000
3,226,046 15,184,997
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, CMS-10250 ,   ,   ,   ,  

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 12,800 40,960,000 0 -40,947,200 0 0
Annual Time Burden (Hours) 3,226,046 15,184,997 0 -11,958,951 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No