Information Collection

Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process

IC 183056 under ICR 202604-0938-022 · OMB 0938-1042.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10224 HCPCS Level II Application Screenshots Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process	Form and Instruction
CMS-10224 HCPCS Level II Application Screenshots HCPCS Level II Application Screenshots.pdf	Form and Instruction
HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) LEVEL II CODING PROCEDURES .pdf HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) LEVEL II CODING PROCEDURES	IC Document

IC Title:

Agency IC Tracking Number:

CM-FFS

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 45 CFR 162.10002 42 CFR 414.40

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 and Instruction	CMS-10224				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	2,500	2,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) LEVEL II CODING PROCEDURES		04/24/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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