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OMB Control No: 0938-1240	ICR Reference No: 202602-0938-015
Status: Received in OIRA	Previous ICR Reference No: 202402-0938-009
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC
Title: National Implementation of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) Survey (CMS-10500)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 02/19/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2026
Responses	2,045,727	2,534,643
Time Burden (Hours)	500,805	614,976
Cost Burden (Dollars)	0	0

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
HOPDs/ASCs Patient Records	CMS-10500, CMS-10500, CMS-10500, CMS-10500, CMS-10500, CMS-10500, CMS-10500, CMS-10500	, , , , , , ,
Individuals	CMS-10500, CMS-10500, CMS-10500, CMS-10500, CMS-10500, CMS-10500	, , , , ,

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	2,045,727	2,534,643	-488,916
Annual Time Burden (Hours)	500,805	614,976	-114,171
Annual Cost Burden (Dollars)	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: Collection burden has decreased due to the total number of HOPDs and ASCs that are expected to participate is based on the current participation rates. The change in number of facilities we expect to participate has decreased to 8,427 from 10,243, due to participation rates since national implementation has been linked to reimbursement.

Annual Cost to Federal Government: $2,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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. No

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. No

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

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