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

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

OMB: 0938-0568

IC ID: 8171

Documents and Forms

Document Name Document Type
Form CMS-P-0015A Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) Form
CMS-P-0015A Cost Payment Summary 2024_Cost_Payment_Summary_CPS.pdf Form
CMS-P-0015A Demographic Income 2025_Demographics_Income_DIQ.pdf Form
CMS-P-0015A End Questionaire 2023_End_END.pdf Form
CMS-P-0015A Enumeration Summary 2023_Enumeration_Summary_ENS.pdf Form
CMS-P-0015A Mobility of Beneficiaries 2023_Mobility_MBQ.pdf Form
CMS-P-0015A Post Statement Cost 2023_Post_Statement_Cost_PSQ.pdf Form
CMS-P-0015A Access to Care 2024_Access_to_Care_ACQ.pdf Form
CMS-P-0015A Chronic Pain 2024_Chronic_Pain_CPQ.pdf Form
CMS-P-0015A Dental, Vision, and Hearing Care Utilization 2023_Den_Vis_Hear_Care_Utl_DVH.pdf Form
CMS-P-0015A Drug Coverage 2025_Drug_Coverage_RXQ.pdf Form
CMS-P-0015A Emergency Utilization 2023_Emergency_Utilization_ERQ.pdf Form
CMS-P-0015A Health Insurance 2024_Health_Insurance_HIQ.pdf Form
CMS-P-0015A Home Health 2023_Home_Health_Utilization_HHQ.pdf Form
CMS-P-0015A Housing_Characteristics 2023_Housing_Charcs_HAQ.pdf Form
CMS-P-0015A Income_and_ Assets 2025_Income_and_Assets_IAQ.pdf Form
CMS-P-0015A Inpatient Utilization 2023_Inpatient_Utilization_IPQ.pdf Form
CMS-P-0015A Institutional Utilization 2023_Institutional_Util_IUQ.pdf Form
CMS-P-0015A Introduction 2025_Introduction_INQ.pdf Form
CMS-P-0015A Medical Provider Utilzation 2023_Medical_Provider_Util_MPQ.pdf Form
CMS-P-0015A Nicotine Alcohol 2023_Nicotine_Alcohol_Use_NAQ.pdf Form
CMS-P-0015A No Statement Cost 2023_No_Statement_Cost_NSQ.pdf Form
CMS-P-0015A Other Medical Expense 2023_Other_Medical_Expense_OMQ.pdf Form
CMS-P-0015A Outpatient Utilization 2023_Outpatient_Utilization_OPQ.pdf Form
CMS-P-0015A Prescribed Medicine Utilization 2023_Prescribed_Med_Util_PMQ.pdf Form
CMS-P-0015A Satisfaction Care 2025_Satisfaction_Care_SCQ.pdf Form
CMS-P-0015A Statement Cost Series 2023_Statement_Cost_Series_STQ.pdf Form
CMS-P-0015A Beneficiary Knowledge 2025_Beneficiary_Knowledge_KNQ.pdf Form
CMS-P-0015A Preventive Care 2025_Preventive_Care_PVQ.pdf Form
CMS-P-0015A Usual Source of Care 2024_Usual_Source_Of_Care_USQ.pdf Form
CMS-P-0015A Showcards and Reference Cards 2024CommShowcards508.pdf Form
CMS-P-0015A Facility Showcards 2024FacilityShowcards508.pdf Form
CMS-P-0015A Facility Screener Fac2023_Facility_Screener_FACSCREEN.pdf Form
CMS-P-0015A Residence History Missing Data Fac2023_Residence_Missing_RHM.pdf Form
CMS-P-0015A Residence History Fac2023_Residence_History_RH.pdf Form
CMS-P-0015A Use of Health Services Fac2024_Health_Status_HS.pdf Form
CMS-P-0015A Background_Questionnaire Fac2023_Background_BQ.pdf Form
CMS-P-0015A Background_Questionnaire MIssing Data Fac2023_Background_Missing_BQM.pdf Form
CMS-P-0015A Expenditures Fac2024_Expenditures_EX.pdf Form
CMS-P-0015A Questionaire Missing Data Fac2023_Facility_Missing_FQM.pdf Form
CMS-P-0015A Questionaire Fac2023_Facility_Quex_FQ.pdf Form
CMS-P-0015A Health_Insurance Fac2023_Health_Insurance_IN.pdf Form
CMS-P-0015A Health_Status Fac2023_Health_Status_HS.pdf Form
CMS-P-0015A Cognitive Measures 2023_Cognitive_Measures_CMQ.pdf Form
CMS-P-0015A HFQ - Health Status and Functioning 2025_Health_Status_HFQ.pdf Form
CMS-P-0015A Physical_Measures 2024_Physical_Measures_PXQ.pdf Form
P-0015A COVID-19 Questionnaire Specifications Fac2024_COVID_19_Bene_CV.pdf Form
P-0015A COVID-19 Facility-Level Supplement 2024_COVID_19_CVQ.pdf Form
CMS-P-0015A Use of Health Services Section Specifications Fac2023_Use_Health_Services_US.pdf Form
CMS-P-0015A Telemedicine Questionnaire 2024_Telemedicine_TLQ.pdf Form
CMS-P-0015A Physical Measures Frequently Asked Questions (FAQ) Sheet ComPhysicalMeasuresFAQ.pdf Form
CMS-P-0015A Immunization 2025_Immunization_IMQ.pdf Form
CMS-P-0015A Health_Status 2025_Health_Status_HFQ.pdf Form
CMS-P-0015A Interviewer_Remarks Fac2023_Interviewer_Remarks_IR.pdf Form
Attachment A - Revised Questionnaires.pdf Track change versions (DIQ, INQ, SCQ) IC Document