Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0907 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10079 Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64 Form and Instruction
CMS-10079 Medicare Wage Index Occupational Mix Survey CMS-10079 Final 2007-2008 Occ Mix Survey_kn_mh.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10079	Medicare Wage Index Occupational Mix Survey	CMS-10079 Final 2007-2008 Occ Mix Survey_kn_mh.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,600	-200	3,800
Annual IC Time Burden (Hours)	1,728,000	512,000	1,216,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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