OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

(CMS-1880) Request for Certification as Supplier of Portable X-Ray and Portable X-Ray Survey Report Form

OMB 0938-0027 · HHS/CMS.

OMB 0938-0027

The Medicare program requires portable X-ray suppliers to be surveyed for health and safety standards. The CMS-1880 is used by the surveyor to determine if a portable X-ray applicant meets the eligibility requirements.

The latest form for (CMS-1880) Request for Certification as Supplier of Portable X-Ray and Portable X-Ray Survey Report Form expires 2021-08-31 and is listed under ICR 201803-0938-010.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-1880 Request for Certification as Supplier of Portable X-Ray and Portable X-Ray Survey Report FormForm and Instruction
Supporting Statement A for CMS-1880 04.20.21.docxSupporting Statement A
Request for Certification as Supplier of Portable X-Ray and Portable X-Ray Survey Report Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202108-0938-004 Revision of a currently approved collection 2021-08-13 Approved without change
201803-0938-010 Revision of a currently approved collection 2018-03-28 Approved with change
201502-0938-001 Extension without change of a currently approved collection 2015-02-04 Approved without change
201405-0938-002 No material or nonsubstantive change to a currently approved collection 2014-05-13 Approved without change
201203-0938-006 Extension without change of a currently approved collection 2012-03-13 Approved without change
200902-0938-008 Extension without change of a currently approved collection 2009-02-13 Approved without change
200512-0938-006 Extension without change of a currently approved collection 2005-12-16 Approved without change
200207-0938-001 Extension without change of a currently approved collection 2002-07-03 Approved without change
199907-0938-001 Reinstatement without change of a previously approved collection 1999-07-01 Approved without change
199603-0938-002 Reinstatement with change of a previously approved collection 1996-03-19 Approved without change
199111-0938-003 Reinstatement with change of a previously approved collection 1991-11-27 Approved without change
198907-0938-003 Extension without change of a currently approved collection 1989-07-05 Approved without change
198605-0938-011 Revision of a currently approved collection 1986-05-19 Approved without change
198405-0938-011 Reinstatement with change of a previously approved collection 1984-05-24 Approved without change
198212-0938-006 Revision of a currently approved collection 1982-12-23 Disapproved and continue
198204-0938-008 Reinstatement with change of a previously approved collection 1982-04-02 Approved without change
198107-0938-020 No material or nonsubstantive change to a currently approved collection 1981-07-28 Approved with change
198102-0938-017 Reinstatement with change of a previously approved collection 1981-02-27 Approved without change
198006-0938-004 Reinstatement with change of a previously approved collection 1980-06-09 Approved without change
197803-0938-018 No material or nonsubstantive change to a currently approved collection 1978-03-29 Approved with change
197710-0938-008 Revision of a currently approved collection 1977-10-03 Approved without change
197709-0938-005 Revision of a currently approved collection 1977-09-13 Not subject to PRA and continue
197412-0938-005 Revision of a currently approved collection 1974-12-16 Approved without change