Recognition of pass-through payment for additional (new) categories of devices under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052)

Recognition of Pass-Through Payment for Additional (New) Categories of Devices Under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052)

OMB: 0938-0857

IC ID: 8672

Information Collection (IC) Details

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Recognition of pass-through payment for additional (new) categories of devices under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 419.66

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10052 Medicare Electronic Application Request Information System Device Pass-through.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

10 2
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10 0 0 0 0 10
Annual IC Time Burden (Hours) 160 0 0 0 0 160
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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