View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Hospital Outpatient Quality Reporting
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10250 Web Based Data Collection Tool HQROQRPRAStatement_Screenshots.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10250.OQR_Withdraw Form CMS-10250.OQR_Withdraw Form CMS-10250.OQR_Withdraw Form.docx Yes Yes Fillable Fileable
Instruction Hospital OQR Specifications Manual, v19.pdf.pdf Yes No Printable Only
Form and Instruction CMS-10250 CMS-10250.HOQR ProgramValidationReconForm CMS-10250.HOQR ProgramValidationReconForm.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10250 CMS.10250.Extraordinary Circumstances Exemption Request Form HQR_ECE_Req_Form_CY_2025.pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10250 CMS Quality Reporting Program APU Reconsideration Request Form CMS Quality Reporting Program APU Reconsideration Request Form.pdf Yes Yes Fillable Fileable

Health Health Care Services

Medicare Beneficiary Database (MBD)  83 FR 6591

3,200 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 40,960,000 0 0 0 0 40,960,000
Annual IC Time Burden (Hours) 9,882,620 0 -5,302,377 0 0 15,184,997
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Summary of Updates SmryHQRInfoClctnForms_CY2026OPPSFinalRule.pdf 08/19/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.