OMB control number
Recognition of Pass-Through Payment for Additional (New) Categories of Devices Under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052)
OMB 0938-0857 · HHS/CMS.
OMB 0938-0857
Information is necessary to determine eligibility of medical devices for establishment of additional device categories for payment under transitional pass-through payment provisions as required by section 1833(t)(6) of the Social Security Act.
The latest form for Recognition of Pass-Through Payment for Additional (New) Categories of Devices Under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052) expires 2029-06-30 and is listed under ICR 202511-0938-009.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 CMS 10052 Supporting Statement.docx | Supporting Statement A |
 Device Pass-through Web Application Crosswalk_All Updates.pdf | Supplementary Document |
 Recognition of pass-through payment for additional (new) categories of devices under the Outpatient Prospective Payment System and Supporting Regulations (CMS-10052) |
Instruction |