View Information Collection Request (ICR) Package
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View ICR - Agency Submission
OMB Control No:
0938-0842
ICR Reference No:
202508-0938-008
Status:
Received in OIRA
Previous ICR Reference No:
202505-0938-002
Agency/Subagency:
HHS/CMS
Agency Tracking No:
CCSQ
Title:
IRF-PAI for the collection of data pertaining to the Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program (CMS-10036)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
Date Submitted to OIRA:
08/07/2025
Requested
Previously Approved
Expiration Date
36 Months From Approved
10/31/2027
Responses
622,300
571,151
Time Burden (Hours)
1,179,256
1,194,814
Cost Burden (Dollars)
0
0
Abstract:
The Centers for Medicare & Medicaid Services (CMS) is requesting approval of revisions to the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) Version 4.1 that will be effective on October 1, 2024. On April 7, 2023 the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) (88 FR 20950) which proposes modifications to the collection of quality reporting data in the Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP). Specifically, CMS proposes to adopt two new measures and remove three measures from the IRF QRP. Per the NPRM, CMS proposes to require IRFs to start collecting assessment data using the IRF-PAI Version 4.2 for IRF patients beginning October 1, 2024.
Authorizing Statute(s):
PL:
Pub.L. 105 - 1 4421
Name of Law: Prospective Payment for Inpatient Rehab Hospital Services
PL:
Pub.L. 111 - 148 3004
Name of Law: Quality Reporting for Long-Term Care Hospitals, etc.
US Code:
42 USC 1395ww(jX2)(d)
Name of Law: Prospective Payment for Inpatient Rehab Services
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
0938-AV48
Final or interim final rulemaking
90 FR 37678
08/05/2025
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Inpatient Rehabilitation Facility - Patient Assessment Instrument
CMS-10036, CMS-10036
IRF- PAI version 4.2
,
IRF- PAI version 4.4
ICR Summary of Burden
Total Request
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
622,300
571,151
0
51,149
0
0
Annual Time Burden (Hours)
1,179,256
1,194,814
0
-15,558
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
We estimate a decrease in the amount of time it will take to complete a single IRF PAI Version 4.4 as compared to the previously approved package. As finalized, the burden will decrease from 106.6 minutes (1,194,814 hours across all IRFs) to 105.1 minutes (1,179,256 hours across all IRFs) beginning October 1, 2026 [(1,194,814 - (1,166 IRFs x 13.34 hr decrease/IRF for FY 2028 IRF QRP) = 1,179,256)].
Annual Cost to Federal Government:
$3,319,952
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
08/07/2025
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