Information Collection

Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System

IC 8584 under ICR 202405-0938-019 · OMB 0938-0802.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10008 Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System	Form and Instruction
CMS-10008 Drug and Biological Pass- Through Application Welcome to the Drug and Biological Pass-Through Application.pdf	Form and Instruction
CMS-10008 Drug and Biological Pass- Through Application Welcome to the Drug and Biological Pass-Through Application.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 419.64

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10008	Drug and Biological Pass- Through Application	Welcome to the Drug and Biological Pass-Through Application.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

Number of Respondents for Small Entity: 2

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	35	5	30
Annual IC Time Burden (Hours)	560	80	480
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.