Information Collection

Alternative NTAP Pathway

IC 262237 under ICR 202605-0938-002 · OMB 0938-1347.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10638 New Technology Add-On Payments (NTAP) Application Overview Alternative NTAP Pathway	Form and Instruction
CMS-10638 New Technology Add-On Payments (NTAP) Application Overvi NTAP Application Changes for PRA Revision (2026-2-3 clean).docx	Form and Instruction
FY_2018_New_Technology_Application.docx	IC Document

IC Title:

Agency IC Tracking Number:

CM-OM

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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-10638				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	375	375
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
		06/28/2017

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

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