OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

National Ambulatory Medical Care Survey (NAMCS)

OMB 0920-0234 · HHS/CDC.

OMB 0920-0234

The purpose of this request is for NAMCS to meet the needs and demands for statistical information about the provision of ambulatory medical care services in the United States; and fulfill NCHS’ mission to collect, analyze, and disseminate timely, relevant, and accurate health data and statistics. Additional justifications for conducting NAMCS include the need for more complete data to study: (1) the performance of the U.S. health care system, (2) care for the rapidly aging population, (3) changes in services such as health insurance coverage, (4) the introduction of new medical technologies, (5) the use of HCs in the health care community, and (6) the use of EHRs. Continue previously approved survey activities for the next 3 years, i.e., completion of the 2024 data year for HCs, conducting the full 2025, 2026, and 2027 data years. Approval to use non-substantive change requests to make small modifications or incorporate experimental and developmental work, including the implementation of planned changes for which the methodology has been explained in the currently approved supporting statements.

The latest form for National Ambulatory Medical Care Survey (NAMCS) expires 2028-03-31 and is listed under ICR 202412-0920-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-0234 Set-up Fee Questionnaire (2024)Form and Instruction
Form 0920-0234 Set-up Fee Questionnaire (H/C staff) (Survey year: 2024)Form and Instruction
Form 0920-0234 EHR Implementation GuideForm and Instruction
Form 0920-0234 EHR Implementation Guide TemplatesForm and Instruction
Form 0920-0234 EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staffForm and Instruction
Form 0920-0234 Attachment O2_NAMCS EHR Record Pulling BurdenForm and Instruction
Form 0920-0234 EHR Implementation Guide TemplatesForm and Instruction
Form 0920-0234 EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staffForm and Instruction
Form 0920-0234 NAMCS Tracing QuestionnaireForm and Instruction
Form 0920-0234 NAMCS Tracing Questionnaire (Survey year: 2026)Form and Instruction
Form 0920-0234 NAMCS Provider Facility Interview (PFI)_10JAN2025Form and Instruction
Form 0920-0234 NAMCS Provider Facility Interview (PFI)Form and Instruction
Form 0920-0234 NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027)Form and Instruction
Form 0920-0234 NAMCS Tracing Questionnaire (Survey year 2025 & 2027)Form and Instruction
Form 0920-0234 NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ AdvancedForm and Instruction
Form 0920-0234 NAMCS Ambulatory Care Provider Interview (ACPI) Advanced Practice Provider Interview_10JAN2025Form and Instruction
Form 0920-0234 NAMCS Ambulatory Care Provider Interview (ACPI) Advanced Practice Provider and their ProxiesForm and Instruction
Form 0920-0234 (ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027)Form and Instruction
Form 0920-0234 Set-up Fee QuestionnaireForm and Instruction
Form 0920-0234 Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027)Form and Instruction
Form 0920-0234 HL7 CDA® R2 Implementation Guide: National Health Care Surveys Release 1,Form and Instruction
Form 0920-0234 National Health Care Surveys Release 1Form and Instruction
Form 0920-0234 NAMCS Electronic Health Record (EHR): Pulling and Sending RecordsForm and Instruction
Form 0920-0234 EHR for Visit Data (quarterly) (2024)Form and Instruction
Form 0920-0234 2025-2027 Health Center Component Facility InterviewForm and Instruction
Form 0920-0234 Health Center Component Facility Interview (Survey year: 2025 & 2027)Form and Instruction
Form 0920-0234 NAMCS Ambulatory Care Provider Interview (ACPI) Providers and their Proxies_10JAN2025Form and Instruction
Form 0920-0234 NAMCS Provider Facility Interview (PFI)Form and Instruction
Form 0920-0234 (ACPI) Providers and their Proxies (Survey year: 2026)Form and Instruction
Form 0920-0234 2024 Health Center Component Facility InterviewForm and Instruction
Form 0920-0234 Health Center Component Facility Interview (Survey year: 2024)Form and Instruction
Attachment E_ACPI_Advanced Practice Provider_clean_03142025.docx (document unavailable)Supplementary Document
Attachment D_ACPI_Provider_clean_03142025.docx (document unavailable)Supplementary Document
Attachment N3_NAMCS PFI Introductory Letters.pdfSupplementary Document
Attachment N3_NAMCS PFI Introductory Letters.pdf Supplementary Document
Attachment Q_System of Records Notice.pdfSupplementary Document
Attachment P_2023 NAMCS Endorsing Organizations.docxSupplementary Document
Attachment N2_NAMCS Provider Survey Component Introductory Letters.pdfSupplementary Document
Attachment N1_NAMCS Health Center Introductory Letters.pdfSupplementary Document
Attachment M_NAMCS ERB Approval Letter.pdfSupplementary Document
Attachment J_Consultants for NAMCS.docxSupplementary Document
Attachment G_Electronic Health Record (EHR) Variable List.xlsxSupplementary Document
Attachment B_60-day Federal Register Notice.pdfSupplementary Document
Attachment A_Authorizing Legislative.pdfSupplementary Document
NAMCS SSB_2025-2027_clean_03172025.docxSupporting Statement B
NAMCS SSB_2025-2027_12052024_CLEAN.docxSupporting Statement B
NAMCS SSA_2025-2027_clean_03142025.docx (document unavailable)Supporting Statement A
NAMCS SSA_2025-2027_12052024_CLEAN.docxSupporting Statement A
Set-up Fee Questionnaire (H/C staff) (Survey year: 2024) Form and Instruction
Set-up Fee Questionnaire (H/C staff) (Survey year: 2024) Form and Instruction
EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff Form and Instruction
EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff Form and Instruction
EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff Form and Instruction
EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff Form and Instruction
EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff Form and Instruction
EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff Form and Instruction
NAMCS Tracing Questionnaire (Survey year: 2026) Form and Instruction
NAMCS Tracing Questionnaire (Survey year: 2026) Form and Instruction
NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027) Form and Instruction
NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027) Form and Instruction
NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027) Form and Instruction
NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ Advanced Form and Instruction
NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ Advanced Form and Instruction
(ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027) Form and Instruction
(ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027) Form and Instruction
(ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027) Form and Instruction
Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027) Form and Instruction
Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027) Form and Instruction
EHR for Visit Data (quarterly) (2024) Form and Instruction
EHR for Visit Data (quarterly) (2024) Form and Instruction
EHR for Visit Data (quarterly) (2024) Form and Instruction
EHR for Visit Data (quarterly) (2024) Form and Instruction
Health Center Component Facility Interview (Survey year: 2025 & 2027) Form and Instruction
Health Center Component Facility Interview (Survey year: 2025 & 2027) Form and Instruction
(ACPI) Providers and their Proxies (Survey year: 2026) Form and Instruction
(ACPI) Providers and their Proxies (Survey year: 2026) Form and Instruction
(ACPI) Providers and their Proxies (Survey year: 2026) Form and Instruction
Health Center Component Facility Interview (Survey year: 2024) Form and Instruction
Health Center Component Facility Interview (Survey year: 2024) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202412-0920-002 Revision of a currently approved collection 2024-12-23
202210-0920-012 Revision of a currently approved collection 2022-10-21 Approved without change
202105-0920-006 Revision of a currently approved collection 2021-06-01 Approved without change
202007-0920-001 No material or nonsubstantive change to a currently approved collection 2020-07-01 Approved without change
201902-0920-021 Revision of a currently approved collection 2019-03-20 Approved with change
201702-0920-007 No material or nonsubstantive change to a currently approved collection 2017-02-16 Approved without change
201602-0920-006 Revision of a currently approved collection 2016-02-11 Approved without change
201411-0920-004 Revision of a currently approved collection 2014-11-20 Approved without change
201309-0920-004 No material or nonsubstantive change to a currently approved collection 2013-09-10 Approved without change
201211-0920-001 No material or nonsubstantive change to a currently approved collection 2012-11-01 Approved without change
201111-0920-001 Revision of a currently approved collection 2011-11-08 Approved without change
201102-0920-016 Revision of a currently approved collection 2011-02-25 Approved without change
201010-0920-006 No material or nonsubstantive change to a currently approved collection 2010-10-15 Approved without change
201002-0920-004 Revision of a currently approved collection 2010-02-04 Approved without change
200906-0920-008 Revision of a currently approved collection 2009-06-16 Approved without change
200905-0920-002 No material or nonsubstantive change to a currently approved collection 2009-05-29 Approved without change
200901-0920-007 No material or nonsubstantive change to a currently approved collection 2009-01-16 Approved without change
200801-0920-003 No material or nonsubstantive change to a currently approved collection 2008-01-04 Approved without change
200709-0920-002 No material or nonsubstantive change to a currently approved collection 2007-09-05 Approved without change
200607-0920-004 Revision of a currently approved collection 2006-07-13 Approved without change
200510-0920-007 No material or nonsubstantive change to a currently approved collection 2005-10-11 Approved without change
200404-0920-002 Revision of a currently approved collection 2004-04-07 Approved with change
200309-0920-004 Extension without change of a currently approved collection 2003-09-26 Approved without change
200303-0920-004 Revision of a currently approved collection 2003-03-21 Approved without change
200302-0920-008 Revision of a currently approved collection 2003-02-28 Withdrawn and continue
200210-0920-001 Revision of a currently approved collection 2002-10-01 Approved without change
200206-0920-004 Revision of a currently approved collection 2002-06-07 Withdrawn and continue
200011-0920-012 No material or nonsubstantive change to a currently approved collection 2000-11-16 Approved without change
200006-0920-006 Revision of a currently approved collection 2000-06-21 Approved without change
199803-0920-002 Revision of a currently approved collection 1998-03-24 Approved without change
199605-0920-005 Revision of a currently approved collection 1996-05-23 Approved without change
199403-0920-006 Revision of a currently approved collection 1994-03-21 Approved without change
199204-0920-008 Revision of a currently approved collection 1992-04-23 Approved without change
199009-0920-004 No material or nonsubstantive change to a currently approved collection 1990-09-19 Approved with change
199004-0920-005 Revision of a currently approved collection 1990-04-23 Approved without change
198905-0920-008 Extension without change of a currently approved collection 1989-05-26 Approved without change
198805-0920-004 New collection (Request for a new OMB Control Number) 1988-05-31 Approved without change

OMB Details

Health Center Component Facility Interview (Survey year: 2024)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-02342024 Health Center Component Facility InterviewFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.