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OMB Control No: 0938-0842	ICR Reference No: 202604-0938-006
Status: Historical Inactive	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
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 06/15/2026
	Date Received in OIRA: 04/13/2026
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is not approved at this time. Prior to publication of the final rule, the agency should provide to OMB a summary of all comments received on the proposed information collection and identify any changes made in response to these comments. Prior to the re-submission of the information collection “IRF-PAI for the collection of data pertaining to the Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program (CMS-10036)” (0938-0842) the agency will assess its respondent burden. This assessment will be guided by the principles and priorities set forth in the Executive Order 14192 title "Unleashing Prosperity Through Deregulation" (January 21, 2025) https://www.whitehouse.gov/presidential-actions/2025/01/unleashing-prosperity-through-deregulation/. The assessment will inform and be integrated in the agency’s next extension or revision of this information collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2027	36 Months From Approved	10/31/2027
Responses	622,300	0	622,300
Time Burden (Hours)	1,179,256	0	1,179,256
Cost Burden (Dollars)	0	0	0

Abstract: The Centers for Medicare & Medicaid Services (CMS) is requesting an extension to the approval of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) Version 4.4 that will be effective on October 1, 2026. Specifically, we are proposing to change the data submission deadlines for data submitted for the purposes of the IRF QRP. If finalized as proposed, these updates would not add any additional collection burden for IRFs. CMS is asking for an extension of the approval of the IRF-PAI Version 4.4, which will have an October 1, 2026 implementation date. The IRF-PAI Version 4.2 will have a runoff period through September 30, 2026 and sunset when the IRF-PAI Version 4.4 takes effect on October 1, 2026.

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-AV76	Proposed rulemaking	91 FR 17195	04/06/2026

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	,

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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