National Ambulatory Medical Care Survey (NAMCS)

Forms and Documents

Document Name	Status
Form 0920-0234 Set-up Fee Questionnaire (H/C staff) (Survey year: 2024) Form and Instruction	Modified
Form 0920-0234 EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff Form and Instruction	Modified
Form 0920-0234 EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff Form and Instruction	Modified
Form 0920-0234 NAMCS Tracing Questionnaire (Survey year: 2026) Form and Instruction	Modified
Form 0920-0234 NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027) Form and Instruction	Modified
Form 0920-0234 NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ Advanced Form and Instruction	Modified
Form 0920-0234 (ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027) Form and Instruction	Modified
Form 0920-0234 Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027) Form and Instruction	Modified
Form 0920-0234 EHR for Visit Data (quarterly) (2024) Form and Instruction	Modified
Form 0920-0234 Health Center Component Facility Interview (Survey year: 2025 & 2027) Form and Instruction	Modified
Form 0920-0234 (ACPI) Providers and their Proxies (Survey year: 2026) Form and Instruction	Modified
Form 0920-0234 Health Center Component Facility Interview (Survey year: 2024) Form and Instruction	Modified
Attachment N3_NAMCS PFI Introductory Letters.pdf Supplementary Document	2024-12-20
Attachment Q_System of Records Notice.pdf Supplementary Document	2024-12-20
Attachment P_2023 NAMCS Endorsing Organizations.docx Supplementary Document	2024-12-20
Attachment N2_NAMCS Provider Survey Component Introductory Letters.pdf Supplementary Document	2024-12-20
Attachment N1_NAMCS Health Center Introductory Letters.pdf Supplementary Document	2024-12-20
Attachment M_NAMCS ERB Approval Letter.pdf Supplementary Document	2024-12-20
Attachment J_Consultants for NAMCS.docx Supplementary Document	2024-12-20
Attachment G_Electronic Health Record (EHR) Variable List.xlsx Supplementary Document	2024-12-20
Attachment B_60-day Federal Register Notice.pdf Supplementary Document	2024-12-20
Attachment A_Authorizing Legislative.pdf Supplementary Document	2024-12-20
NAMCS SSB_2025-2027_12052024_CLEAN.docx Supporting Statement B	2024-12-20
NAMCS SSA_2025-2027_12052024_CLEAN.docx Supporting Statement A	2024-12-20

IC Document Collections

IC ID	Document Title	Status
256557	Set-up Fee Questionnaire (H/C staff) (Survey year: 2024) Form and Instruction	Modified
256556	EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff Form and Instruction	Modified
256555	EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff Form and Instruction	Modified
256554	NAMCS Tracing Questionnaire (Survey year: 2026) Form and Instruction	Modified
256553	NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027) Form and Instruction	Modified
256552	NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ Advanced Form and Instruction	Modified
256551	(ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027) Form and Instruction	Modified
256550	Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027) Form and Instruction	Modified
247678	EHR for Visit Data (quarterly) (2024) Form and Instruction	Modified
247676	Health Center Component Facility Interview (Survey year: 2025 & 2027) Form and Instruction	Modified
247675	(ACPI) Providers and their Proxies (Survey year: 2026) Form and Instruction	Modified
220059	Health Center Component Facility Interview (Survey year: 2024) Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0234	ICR Reference No: 202412-0920-002
Status: Received in OIRA	Previous ICR Reference No: 202210-0920-012
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0234
Title: National Ambulatory Medical Care Survey (NAMCS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 12/23/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2025
Responses	36,291	83,206
Time Burden (Hours)	22,107	37,744
Cost Burden (Dollars)	0	0

---

Abstract: The purpose of this request is for NAMCS to meet the needs and demands for statistical information about the provision of ambulatory medical care services in the United States; and fulfill NCHS’ mission to collect, analyze, and disseminate timely, relevant, and accurate health data and statistics. Additional justifications for conducting NAMCS include the need for more complete data to study: (1) the performance of the U.S. health care system, (2) care for the rapidly aging population, (3) changes in services such as health insurance coverage, (4) the introduction of new medical technologies, (5) the use of HCs in the health care community, and (6) the use of EHRs. Continue previously approved survey activities for the next 3 years, i.e., completion of the 2024 data year for HCs, conducting the full 2025, 2026, and 2027 data years. Approval to use non-substantive change requests to make small modifications or incorporate experimental and developmental work, including the implementation of planned changes for which the methodology has been explained in the currently approved supporting statements.

---

Authorizing Statute(s): PL: Pub.L. 111 - 5 1512 Name of Law: American Recovery and Reinvestment Act of 2009
   US Code: 42 USC 242K Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 77158	09/20/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 104160	12/20/2024
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 12

IC Title	Form No.	Form Name
(ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027)	0920-0234	NAMCS Ambulatory Care Provider Interview (ACPI) Advanced Practice Provider and their Proxies
EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff	0920-0234, 0920-0234	EHR Implementation Guide Templates ,   Attachment O2_NAMCS EHR Record Pulling Burden
(ACPI) Providers and their Proxies (Survey year: 2026)	0920-0234	NAMCS Provider Facility Interview (PFI)
EHR for Visit Data (quarterly) (2024)	0920-0234, 0920-0234, 0920-0234	NAMCS Electronic Health Record (EHR): Pulling and Sending Records ,   National Health Care Surveys Release 1 ,   HL7 CDA® R2 Implementation Guide: National Health Care Surveys Release 1,
EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff	0920-0234, 0920-0234	EHR Implementation Guide Templates ,   EHR Implementation Guide
Health Center Component Facility Interview (Survey year: 2024)	0920-0234	2024 Health Center Component Facility Interview
Health Center Component Facility Interview (Survey year: 2025 & 2027)	0920-0234	2025-2027 Health Center Component Facility Interview
NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027)	0920-0234	NAMCS Provider Facility Interview (PFI)
NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ Advanced	0920-0234	NAMCS Tracing Questionnaire (Survey year 2025 & 2027)
NAMCS Tracing Questionnaire (Survey year: 2026)	0920-0234	NAMCS Tracing Questionnaire
Set-up Fee Questionnaire (H/C staff) (Survey year: 2024)	0920-0234	Set-up Fee Questionnaire (2024)
Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027)	0920-0234	Set-up Fee Questionnaire

---

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	36,291	83,206	0	-46,915	0	0
Annual Time Burden (Hours)	22,107	37,744	0	-15,637	0	0
Annual Cost Burden (Dollars)	0	0	0	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: Currently there are 37,744 hours in the OMB inventory for NAMCS. The Program is requesting 22,107 total burden hours. The decreased sample size for the HC Component and the Provider Survey Component in the current NAMCS OMB package will decrease the requested burden by 15,637 hours.

---

Annual Cost to Federal Government: $6,886,674

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.     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]? 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? Yes

---

Common Form ICR:  Yes

Description/Changes for Common Form Usage:  The Survey contains fixed and rotational components, which will allow swift updates/additions when quick turnaround is necessary, for example the addition of COVID-19 questions during the 2020 data collection. The decreased sample size for the HC Component and the Provider Survey Component in the current NAMCS OMB package will decrease the requested burden hours.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

---

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: 12/23/2024

---