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OMB Control No: 0938-0338	ICR Reference No: 202606-0938-011
Status: Received in OIRA	Previous ICR Reference No: 202110-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Medicare and Medicaid Programs: Conditions of Participation for Portable X-ray Suppliers (CMS-R-43)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 06/17/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,080	0
Time Burden (Hours)	340	0
Cost Burden (Dollars)	0	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,080	68	1,012
Annual Time Burden (Hours)	340	16	324
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The estimated annual burden hours to the industry increased from 324 to 340 hours, a 4.9% increase because the number of suppliers increased from 506 to 540. The annual cost increased from $12,312 to $14,960, a 21.5% increase due to the increased number of suppliers and higher hourly wage due to inflation (from $38 to $44).

Annual Cost to Federal Government: $6,390

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. 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]? No

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: Denise King 410 786-1013 Denise.King@cms.hhs.gov

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