Information Collection Request

Medicare Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (CMS-10931)

ICR 202603-0938-009 · OMB 0938-1487 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10931 OPPS Drug Acquisition Cost Survey Form and Instruction Modified Available
0938-1487 (CMS-10931.Justfication of Non-substantive Change Memo)_ Clean.docx Justification for No Material/Nonsubstantive Change Uploaded 2026-03-20 Available
CMS-10931_Supporting Statement - Part B_ODACS.docx Supporting Statement B Uploaded 2025-11-25 Available
CMS-10931_Supporting Statement - Part A_Clean.docx Supporting Statement A Uploaded 2026-03-20 Available
Comments and Responses_ODACS.docx Supplementary Document Uploaded 2025-11-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
276343 OPPS Drug Acquisition Cost Survey Form and Instruction ModifiedOPPS Drug Acquisition Cost Survey
276343 OPPS Drug Acquisition Cost Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2028 12/31/2028 12/31/2028
4,500 0 4,500
362,250 0 362,250
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
OPPS Drug Acquisition Cost Survey CMS-10931

table that charts list of burden
  Total Approved 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 4,500 4,500 0 0 0 0
Annual Time Burden (Hours) 362,250 362,250 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No