Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)

Documents and forms in this information collection

Document Name	Document Type
Form CMS-P-0015A Cost Payment Summary Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Demographic Income Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A End Questionaire Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Enumeration Summary Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Mobility of Beneficiaries Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Post Statement Cost Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Care_Coordination Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Chronic Pain Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Dental, Vision, and Hearing Care Utilization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Drug Coverage Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Emergency Utilization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Health Insurance Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Home Health Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Housing_Characteristics Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Income_and_ Assets Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Inpatient Utilization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Institutional Utilization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Introduction Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Medical Provider Utilzation Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Nicotine Alcohol Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A No Statement Cost Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Other Medical Expense Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Outpatient Utilization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Prescribed Medicine Utilization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Satisfaction Care Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Statement Cost Series Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Beneficiary Knowledge Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Preventive Care Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Showcards and Reference Cards Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Facility Showcards Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Facility Screener Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Residence History Missing Data Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Residence History Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Health_Status Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Background_Questionnaire Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Background_Questionnaire MIssing Data Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Expenditures Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Questionaire Missing Data Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Questionaire Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Health_Insurance Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Cognitive Measures Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A HFQ - Health Status and Functioning Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Use of Health Services Section Specifications Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Telemedicine Questionnaire Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Immunization Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Health_Status - Hypertension Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Debt Questionaire Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Facility Web Survey 1 - FQ_RH_BQ Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Facility Web Survey 2 - IN_EX Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
Form CMS-P-0015A Facility Web Survey 3 - US_HS Medicare Current Beneficiary Survey (MCBS):(CMS-P-0015A)	Form
CMS-P-0015A Cost Payment Summary 2025_Cost_Payment_Summary_CPS.pdf	Form
CMS-P-0015A Demographic Income 2027_Demographics_Income_DIQ.pdf	Form
CMS-P-0015A End Questionaire 2025_End_END.pdf	Form
CMS-P-0015A Enumeration Summary 2027_Enumeration_Summary_ENS.pdf	Form
CMS-P-0015A Mobility of Beneficiaries 2025_Mobility_MBQ.pdf	Form
CMS-P-0015A Post Statement Cost 2025_Post_Statement_Cost_PSQ.pdf	Form
CMS-P-0015A Care_Coordination 2027_Care_Coordination_CCQ.pdf	Form
CMS-P-0015A Chronic Pain 2025_Chronic_Pain_CPQ.pdf	Form
CMS-P-0015A Dental, Vision, and Hearing Care Utilization 2025_Den_Vis_Hear_Care_Utl_DVH.pdf	Form
CMS-P-0015A Drug Coverage 2027_Drug_Coverage_RXQ.pdf	Form
CMS-P-0015A Emergency Utilization 2025_Emergency_Utilization_ERQ.pdf	Form
CMS-P-0015A Health Insurance 2026_Health_Insurance_HIQ.pdf	Form
CMS-P-0015A Home Health 2025_Home_Health_Util_HHQ.pdf	Form
CMS-P-0015A Housing_Characteristics 2025_Housing_Charcs_HAQ.pdf	Form
CMS-P-0015A Income_and_ Assets 2027_Income_and_Assests_IAQ.pdf	Form
CMS-P-0015A Inpatient Utilization 2025_Inpatient_Utilization_IPQ.pdf	Form
CMS-P-0015A Institutional Utilization 2025_Institutional_Util_IUQ.pdf	Form
CMS-P-0015A Introduction 2025_Introduction_INQ.pdf	Form
CMS-P-0015A Medical Provider Utilzation 2025_Medical_Provider_Util_MPQ.pdf	Form
CMS-P-0015A Nicotine Alcohol 2025_Nicotine_Alcohol_Use_NAQ.pdf	Form
CMS-P-0015A No Statement Cost 2025_No_Statement_Cost_NSQ.pdf	Form
CMS-P-0015A Other Medical Expense 2025_Other_Medical_Expense_OMQ.pdf	Form
CMS-P-0015A Outpatient Utilization 2025_Outpatient_Util_OPQ.pdf	Form
CMS-P-0015A Prescribed Medicine Utilization 2025_Prescribed_Med_Util_PMQ.pdf	Form
CMS-P-0015A Satisfaction Care 2027_Satisfaction_Care_SCQ.pdf	Form
CMS-P-0015A Statement Cost Series 2025_Statement_Cost_Series_STQ.pdf	Form
CMS-P-0015A Beneficiary Knowledge 2027_Beneficiary_Knowledge_KNQ.pdf	Form
CMS-P-0015A Preventive Care 2027_Preventive_Care_PVQ.pdf	Form
CMS-P-0015A Showcards and Reference Cards 2027CommShowcards508 - Final.pdf	Form
CMS-P-0015A Facility Showcards 2027FacilityShowcards508.pdf	Form
CMS-P-0015A Facility Screener Attachment 3. Facility Screener.pdf	Form
CMS-P-0015A Residence History Missing Data Fac2025_Residence_Missing_RHM.pdf	Form
CMS-P-0015A Residence History Fac2025_Residence_History_RH.pdf	Form
CMS-P-0015A Health_Status Fac2025_Health_Status_HS.pdf	Form
CMS-P-0015A Background_Questionnaire Fac2025_Background_BQ.pdf	Form
CMS-P-0015A Background_Questionnaire MIssing Data Fac2025_Background_Missing_BQM.pdf	Form
CMS-P-0015A Expenditures Fac2025_Expenditures_EX.pdf	Form
CMS-P-0015A Questionaire Missing Data Fac2025_Facility_Missing_FQM.pdf	Form
CMS-P-0015A Questionaire Fac2025_Facility_Quex_FQ.pdf	Form
CMS-P-0015A Health_Insurance Fac2025_Health_Insurance_IN.pdf	Form
CMS-P-0015A Cognitive Measures 2025_Cognitive_Measures_CMQ.pdf	Form
CMS-P-0015A HFQ - Health Status and Functioning 2027_Health_Status_HFQ.pdf	Form
CMS-P-0015A Use of Health Services Section Specifications Fac2025_Use_Health_Services_US.pdf	Form
CMS-P-0015A Telemedicine Questionnaire 2025_Telemedicine_TLQ.pdf	Form
CMS-P-0015A Immunization 2027_Immunization_IMQ.pdf	Form
CMS-P-0015A Health_Status - Hypertension 2027_Health_Status_HFQ_Hypertension.pdf	Form
CMS-P-0015A Debt Questionaire 2025_Debt_DBQ.pdf	Form
CMS-P-0015A Facility Web Survey 1 - FQ_RH_BQ Fac2027_Web1_FQ_RH_BQ.pdf	Form
CMS-P-0015A Facility Web Survey 2 - IN_EX Fac2027_Web2_IN_EX.pdf	Form
CMS-P-0015A Facility Web Survey 3 - US_HS Fac2027_Web3_US_HS.pdf	Form
Item Level Crosswalk_07152026.pdf Item Crosswalk (60-day)	IC Document

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