Hospitals and Health Care Complex Cost Report (CMS-2552-10)

ICR 202206-0938-017

OMB: 0938-0050

Federal Form Document

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ICR Details
0938-0050 202206-0938-017
Received in OIRA 201902-0938-008
Hospitals and Health Care Complex Cost Report (CMS-2552-10)
Reinstatement with change of a previously approved collection   No
Regular 06/23/2022
  Requested Previously Approved
36 Months From Approved
6,075 0
4,094,550 0
0 0

The Form CMS-2552-10 cost report is needed to determine a provider's reasonable costs incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or due from a provider.

PL: Pub.L. 111 - 148 3132, 10501(i)(3)(A) Name of Law: Affordable Care Act
   Statute at Large: 18 Stat. 1861
   US Code: 42 USC 413.20 Name of Law: Financial data and reports
   US Code: 42 USC 413.24 Name of Law: Adequate cost data and cost finding
   Statute at Large: 18 Stat. 1815
   Statute at Large: 18 Stat. 1834

Not associated with rulemaking

  85 FR 71653 11/10/2020
87 FR 37338 06/22/2022

IC Title Form No. Form Name
Hospitals and Health Care Complex Cost Report (CMS-2552-10) CMS-2552-10 CMS-2552-10. Hospitals and Health Care Complex Cost Report Worksheets

  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 6,075 0 0 0 -13 6,088
Annual Time Burden (Hours) 4,094,550 0 0 0 -2,674 4,097,224
Annual Cost Burden (Dollars) 0 0 0 0 0 0
This is a reinstatement with change. The burden been adjusted based on revisions to the number of respondents as well as updates to the BLS wage date. Also, the burden has been revised to account for the addition of Worksheet S-10, Part II.

William Parham 410 786-4669 [email protected]


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:
    (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;
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.

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