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Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64

IC 8747 under ICR 202511-0938-008 · OMB 0938-0907.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Other-Introduction
Other-Introduction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64 CM-FFS
 
No Modified
 
Mandatory
 
42 CFR 412.64

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10079 Wage Index Occupational Mix Survey Data CY 2025 HOSPITAL FORM CMS- 10079 OM Survey.xlsx Yes Yes Fillable Fileable
Other-Introduction CY_2022_CMS-10079_Medicare_Wage_Index_Occupational_Mix_Survey.docx Yes Yes Printable Only

Health Health Care Services

 

3,100 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 3,100 0 -100 0 0 3,200
Annual IC Time Burden (Hours) 1,488,000 0 -48,000 0 0 1,536,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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