OMB control number
Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549)
OMB 0938-1275 · HHS/CMS.
OMB 0938-1275
This OMB generic clearance request is for Medicare Current Beneficiary Survey (MCBS) Questionnaire Testing and Methodological Research. This request encompasses development and testing of MCBS questionnaires, instrumentation, as well as methodological experiments. The MCBS (OMB No. 0938-0568) is an in-person, nationally-representative, longitudinal survey of Medicare beneficiaries.
The latest form for Generic Clearance for Questionnaire Testing and Methodological Research for the Medicare Current Beneficiary Survey (MCBS) (CMS-10549) expires 2027-06-30 and is listed under ICR 202404-0938-005.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-10549 Test Questionnaire | Form and Instruction |
 CMS-10549_Supporting_Statement_Part_A.docx | Supporting Statement A |
| CMS-10549_Supporting_Statement_Part_B.docx | Supporting Statement B |
 Test of the MCBS Pulse Supplement: Beneficiary Trust |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202404-0938-005 | Revision of a currently approved collection | 2024-04-08 | Approved without change | |
| 202012-0938-015 | Revision of a currently approved collection | 2020-12-29 | ||
| 202004-0938-011 | No material or nonsubstantive change to a currently approved collection | 2020-05-03 | Approved without change | |
| 201801-0938-008 | Extension without change of a currently approved collection | 2018-01-24 | Approved with change | |
| 201508-0938-002 | No material or nonsubstantive change to a currently approved collection | 2015-08-03 | Approved without change | |
| 201504-0938-003 | New collection (Request for a new OMB Control Number) | 2015-04-02 | Approved without change |