Information Collection Request

Medical Expenditure Panel Survey - Household and Medical Provider Components

ICR 202603-0935-001 · OMB 0935-0118 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 47 Telehealth Section Form and Instruction Modified Available
Form 46 Start-Restart Section Form and Instruction Modified Available
Form 45 Review of Employment Section Form and Instruction Modified Available
Form 43 Reenumeration Section B Section Form and Instruction Modified Available
Form 42 Renumeration A Section Form and Instruction Modified Available
Form 41 Quality Supplement Section Form and Instruction Modified Available
Form 40 Provider Roster Section Form and Instruction Modified Available
Form 39 Old Public Related Insurance Section Form and Instruction Modified Available
Form 38 Provider Probes Section Form and Instruction Modified Available
Form 37 Prescribed Medicines Section Form and Instruction Modified Available
Form 36 Priority Condition Enumeration Section Form and Instruction Modified Available
Form 35 Outpatient Department Section Form and Instruction Modified Available
Form 34 Other Medical Expenses Section Form and Instruction Modified Available
Form 33 Off Path Navigation Section Form and Instruction Modified Available
Form 32 Old Empl-Priv Related Ins Section Form and Instruction Modified Available
Form 31 Medical Visit Section Form and Instruction Modified Available
Form 30 Managed Care Section Form and Instruction Modified Available
Form 29 Income Section Form and Instruction Modified Available
Form 28 Institutional Care Stay Section Form and Instruction Modified Available
Form 27 Health Insurance Section Form and Instruction Modified Available
Form 26 Hospital Stay Section Form and Instruction Modified Available
Form 25 Time Period Covered Detail Section Form and Instruction Modified Available
Form 24 Health Insurance Detail Section Form and Instruction Modified Available
Form 23 Home Health Section Form and Instruction Modified Available
Form 22 Health Status Section Form and Instruction Modified Available
Form 21 Global Section Form and Instruction Modified Available
Form 20 Financial Well Being Section Form and Instruction Modified Available
Form 19 Food Security Section Form and Instruction Modified Available
Form 18 Flat Fee Section Form and Instruction Modified Available
Form 17 Employment Wages Section Form and Instruction Modified Available
Form 16 Event Roster Section Form and Instruction Modified Available
Form 15 Emergency Room Section Form and Instruction Modified Available
Form 14 Employment Driver Section Form and Instruction Modified Available
Form 13 Employment Section Form and Instruction Modified Available
Form 12 Event Follow Up Section Form and Instruction Modified Available
Form 11 Event Enumeration Section Form and Instruction Modified Available
Form 10 Event Driver Section Form and Instruction Modified Available
Form 9 Dental Visit Section Form and Instruction Modified Available
Form 8 Child Preventive Health Section Form and Instruction Modified Available
Form 7 Charge Payment Section Form and Instruction Modified Available
Form 6 Contracting Module Form and Instruction Modified Available
Form 5 Closing Section Form and Instruction Modified Available
Form 4 Calendar Section Form and Instruction Modified Available
Form 3 Assets Form and Instruction Modified Available
Form 2 Additional Questions Form and Instruction Modified Available
Form 1 Access to Care Form and Instruction Modified Available
Form 63 Burdens and Economic Impacts of Medical Care SAQ Form and Instruction Removed Available
Form 50 PSAQ Form and Instruction Modified Available
Form 49 Adult SAQ Form and Instruction Modified Available
Form 54 MPC Contact Guide and Screening Call Form and Instruction Modified Available
Form 53a Validation Letter Form and Instruction Modified Available
Form 53b Phone Validation Form Form and Instruction Modified Available
Form 52 Permission Form for Pharmacies Form and Instruction Modified Available
Form 51 Permission Form for Medical Providers Form and Instruction Modified Available
Form 61 Pharmacies Event Form Form and Instruction Modified Available
Form 60 Institutions (non-hospital) Event Form Form and Instruction Modified Available
Form 59 Hospital Event Form Form and Instruction Modified Available
Form 58 Separately Billing Doctors Event Form Form and Instruction Modified Available
Form 57 Office Based Provider Form Form and Instruction Modified Available
Form 56 Home Healthcare for Non-healthcare Providers Form and Instruction Modified Available
Form 55 Home Healthcare for Healthcare Providers Event Form Form and Instruction Modified Available
Form 50 Diabetes Care SAQ Form and Instruction Removed Available
Supporting Statement Part B_MEPS-HC-MPC_2026 Final 02202026.docx Supporting Statement B Uploaded 2026-03-24 Available
Supporting Statement Part A_MEPS-HC-MPC_2026 Final 20260312 CLEAN.docx Supporting Statement A Uploaded 2026-03-24 Available
Attachment A Data Security Plan.pdf Supplementary Document Uploaded 2026-03-05 Available
IC Document Collections
IC IDCollectionTypeStatusForm
37877 MEPS-HC Core Interview Form and Instruction ModifiedTelehealth Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedStart-Restart Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedReview of Employment Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedReenumeration Section B Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedRenumeration A Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedQuality Supplement Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedProvider Roster Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedOld Public Related Insurance Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedProvider Probes Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedPrescribed Medicines Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedPriority Condition Enumeration Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedOutpatient Department Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedOther Medical Expenses Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedOff Path Navigation Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedOld Empl-Priv Related Ins Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedMedical Visit Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedManaged Care Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedIncome Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedInstitutional Care Stay Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedHealth Insurance Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedHospital Stay Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedTime Period Covered Detail Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedHealth Insurance Detail Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedHome Health Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedHealth Status Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedGlobal Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedFinancial Well Being Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedFood Security Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedFlat Fee Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEmployment Wages Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEvent Roster Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEmergency Room Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEmployment Driver Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEmployment Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEvent Follow Up Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEvent Enumeration Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedEvent Driver Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedDental Visit Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedChild Preventive Health Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedCharge Payment Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedContracting Module
37877 MEPS-HC Core Interview Form and Instruction ModifiedClosing Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedCalendar Section
37877 MEPS-HC Core Interview Form and Instruction ModifiedAssets
37877 MEPS-HC Core Interview Form and Instruction ModifiedAdditional Questions
37877 MEPS-HC Core Interview Form and Instruction ModifiedAccess to Care
269113 Burdens and Economic Impacts of Medical Care SAQ Form and Instruction RemovedBurdens and Economic Impacts of Medical Care SAQ
264315 Preventive Care SAQ Form and Instruction ModifiedPSAQ
264201 Adult SAQ Form and Instruction ModifiedAdult SAQ
204200 MPC Contact Guide/Screening Call Form and Instruction ModifiedMPC Contact Guide and Screening Call
204199 MEPS-HC Validation Interview Form and Instruction ModifiedValidation Letter
204199 MEPS-HC Validation Interview Form and Instruction ModifiedPhone Validation Form
204197 Authorization Form for the MEPS-MPC Provider and Pharmacy Survey Form and Instruction ModifiedPermission Form for Pharmacies
204197 Authorization Form for the MEPS-MPC Provider and Pharmacy Survey Form and Instruction ModifiedPermission Form for Medical Providers
191107 Pharmacies Event Form Form and Instruction ModifiedPharmacies Event Form
191106 Institutions (non-hospital) Event Form Form and Instruction ModifiedInstitutions (non-hospital) Event Form
191105 Hospitals Event Form Form and Instruction ModifiedHospital Event Form
191104 Separately Billing Doctors Form Form and Instruction ModifiedSeparately Billing Doctors Event Form
191103 Office Based Providers Form Form and Instruction ModifiedOffice Based Provider Form
191101 Home Health Care Providers Event Form Form and Instruction ModifiedHome Healthcare for Non-healthcare Providers
191101 Home Health Care Providers Event Form Form and Instruction ModifiedHome Healthcare for Healthcare Providers Event Form
191099 Diabetes Care SAQ Form and Instruction RemovedDiabetes Care SAQ
ICR Details
0935-0118 202603-0935-001
Received in OIRA 202406-0935-002
HHS/AHRQ
Medical Expenditure Panel Survey - Household and Medical Provider Components
Revision of a currently approved collection   No
Regular 04/01/2026
  Requested Previously Approved
36 Months From Approved 09/30/2026
239,027 384,693
50,264 67,489
3,108,705 0

The MEPS was initiated in 1996. Each year a new panel of sample households is selected. Recent annual MEPS-HC sample sizes average about 13,500 households. Data can be analyzed at either the person, family, or event level. The panel design of the survey, which includes 5 Rounds of interviews covering 2 full calendar years, provides data for examining person level changes in selected variables such as expenditures, health insurance coverage, and health status (see Medical Expenditure Panel Survey Content Summary of the Household Interview (ahrq.gov) for information on how the Covid-19 pandemic impacted this design). Using a combination of computer assisted personal interviewing (CAPI), computer assisted video interviewing (CAVI), and self-administered paper and web questionnaires, information about each household member is collected, and the survey builds on this information from interview to interview. CAVI is a new data collection technology and offers the best of both telephone and in-person interviewing, while offering opportunities for cost savings and more accurate reporting. This Information Collection Request (ICR) is for a revision to the Medical Expenditures Panel Survey – Household Component (MEPS-HC). These changes will be fielded in the Spring and Fall of 2025 and includes the addition of the Burdens and Economic Impacts of Medical Care Self-Administered Questionnaire (ESAQ), minor changes to questions in both the Core MEPS Interview and the Adult SAQ and removing the Cancer SAQ (CSAQ).

US Code: 42 USC 299 Name of Law: Agency for Healthcare Research and Quality Act of 1999
  
None

Not associated with rulemaking

  90 FR 61150 12/30/2025
91 FR 15999 03/31/2026
Yes

12
IC Title Form No. Form Name
Adult SAQ 49 Adult SAQ
Authorization Form for the MEPS-MPC Provider and Pharmacy Survey 51, 52 Permission Form for Medical Providers ,   Permission Form for Pharmacies
Burdens and Economic Impacts of Medical Care SAQ 63 Burdens and Economic Impacts of Medical Care SAQ
Diabetes Care SAQ 50 Diabetes Care SAQ
Home Health Care Providers Event Form 56, 55 Home Healthcare for Healthcare Providers Event Form ,   Home Healthcare for Non-healthcare Providers
Hospitals Event Form 59 Hospital Event Form
Institutions (non-hospital) Event Form 60 Institutions (non-hospital) Event Form
MEPS-HC Core Interview 15, 34, 16, 17 , 35, 18 , 19 , 20 , 36, 37, 38 , 39 , 40 , 41, 42, 43, 3, 2, 1, 7, 4, 5, 6, 8 , 9 , 10 , 11, 12, 13, 14, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 , 31, 32, 33, 45, 46, 47 Access to Care ,   Additional Questions ,   Assets ,   Calendar Section ,   Closing Section ,   Contracting Module ,   Charge Payment Section ,   Child Preventive Health Section ,   Dental Visit Section ,   Event Driver Section ,   Event Enumeration Section ,   Event Follow Up Section ,   Employment Section ,   Employment Driver Section ,   Emergency Room Section ,   Event Roster Section ,   Employment Wages Section ,   Flat Fee Section ,   Food Security Section ,   Financial Well Being Section ,   Global Section ,   Health Status Section ,   Home Health Section ,   Health Insurance Detail Section ,   Time Period Covered Detail Section ,   Hospital Stay Section ,   Health Insurance Section ,   Institutional Care Stay Section ,   Income Section ,   Managed Care Section ,   Medical Visit Section ,   Old Empl-Priv Related Ins Section ,   Off Path Navigation Section ,   Other Medical Expenses Section ,   Outpatient Department Section ,   Priority Condition Enumeration Section ,   Prescribed Medicines Section ,   Provider Probes Section ,   Old Public Related Insurance Section ,   Provider Roster Section ,   Quality Supplement Section ,   Renumeration A Section ,   Reenumeration Section B Section ,   Review of Employment Section ,   Start-Restart Section ,   Telehealth Section
MEPS-HC Validation Interview 53a, 53b Phone Validation Form ,   Validation Letter
MPC Contact Guide/Screening Call 54 MPC Contact Guide and Screening Call
Office Based Providers Form 57 Office Based Provider Form
Pharmacies Event Form 61 Pharmacies Event Form
Preventive Care SAQ 50 PSAQ
Separately Billing Doctors Form 58 Separately Billing Doctors Event Form

  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 239,027 384,693 0 -5,675 -139,991 0
Annual Time Burden (Hours) 50,264 67,489 0 0 -17,225 0
Annual Cost Burden (Dollars) 3,108,705 0 0 0 3,108,705 0
No
No

$63,897,239
Yes Part B of Supporting Statement
    Yes
    Yes
No
No
No
No
Margie Shofer 301 427-1696 [email protected]

  No

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.
04/01/2026