OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 (CMS-2744)

OMB 0938-0447 · HHS/CMS.

OMB 0938-0447

The ESRD Facility Survey form (CMS-2744) is completed annually by Medicare-approved providers of dialysis and transplant services. The CMS-2744 is designed to collect information concerning treatment trends utilization of services and patterns of practice in treating ESRD patients.

The latest form for End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 (CMS-2744) expires 2028-09-30 and is listed under ICR 202505-0938-013.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-2744 B ESRD Medical Information System ESRD Facility SurveyForm
Form CMS-2744A&B END STAGE RENAL DISEASE MEDICAL INFORMATION SYSTEM ESRD FACILITY SURVEYForm
Form CMS-2744A&B End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133Form
CMS-2744 Response to Comments For 30 Day comments 9-26-25_final v2.docxSupplementary Document
Kidney Care Council Comment to CMS 2744 Proposed Changes Final 6-30-25.pdf (document unavailable)Public Comments
PC_202505-0938-013_063025_062715_1.pdf (document unavailable)Public Comments
DVA Comments_Form 2744.pdfPublic Comments
PC_202505-0938-013_063025_041928_1.pdfPublic Comments
FME Comment CMS 2744 June 2025 (1).pdfPublic Comments
comment 3.pdf (document unavailable)Public Comments
comment 2.pdfPublic Comments
comment 1.pdf (document unavailable)Public Comments
CMS- 2744 Response to Public Comments 1-17-25.docxSupplementary Document
CMS-2744 Supporting Statement Part B 1-17-25.docxSupporting Statement B
CMS- 2744 Supporting Statement 1-17-25.docxSupporting Statement A
CMS- 2744 Supporting Statement 1-17-25.docxSupporting Statement A
End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 Form
End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 Form
End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 Form
End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133 Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202505-0938-013 Reinstatement with change of a previously approved collection 2025-06-17
202005-0938-001 Reinstatement with change of a previously approved collection 2020-05-07 Approved without change
201612-0938-024 Extension without change of a currently approved collection 2016-12-29 Approved without change
201308-0938-023 Extension without change of a currently approved collection 2013-08-23 Approved without change
201007-0938-004 Reinstatement without change of a previously approved collection 2010-07-14 Approved without change
200609-0938-003 Extension without change of a currently approved collection 2006-09-21 Approved without change
200311-0938-006 Revision of a currently approved collection 2003-11-17 Approved without change
200302-0938-002 Extension without change of a currently approved collection 2003-02-21 Approved without change
200002-0938-006 Extension without change of a currently approved collection 2000-02-24 Approved without change
199704-0938-008 Extension without change of a currently approved collection 1997-04-30 Approved without change
199606-0938-005 Reinstatement with change of a previously approved collection 1996-06-20 Approved without change
199303-0938-008 Revision of a currently approved collection 1993-03-24 Approved without change
199008-0938-002 Extension without change of a currently approved collection 1990-08-15 Approved without change
199004-0938-006 Revision of a currently approved collection 1990-04-09 Approved without change
198806-0938-002 Revision of a currently approved collection 1988-06-06 Approved without change
198708-0938-017 No material or nonsubstantive change to a currently approved collection 1987-08-12 Approved with change
198608-0938-020 No material or nonsubstantive change to a currently approved collection 1986-08-01 Approved with change
198508-0938-004 New collection (Request for a new OMB Control Number) 1985-08-09 Approved without change