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OMB Control No: 0938-0842	ICR Reference No: 202604-0938-006
Status: Received in OIRA	Previous ICR Reference No: 202508-0938-008
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: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 04/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2027
Responses	660,788	622,300
Time Burden (Hours)	1,156,379	1,179,256
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	660,788	622,300	38,488
Annual Time Burden (Hours)	1,156,379	1,179,256	-22,877
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: No

Burden Reduction Due to:

Short Statement: There are no changes to burden since the approval of the IRF-PAI v4.4 was approved. Additionally, new information demonstrates a change in the number of IRFs. The number of IRFs has increased from 1,166 to 1,175 .

Annual Cost to Federal Government: $3,384,268

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

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