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

Forms and Documents

Document Name	Status
Form CMS-P-0015A Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) Form	Modified
CMS-P-0015A 0938-0568_SSA.docx Supporting Statement A	2025-11-21
CMS-P-0015A_0938-0568_SSB.docx Supporting Statement B	2025-11-19
2026 Full Clearance 30-Day Crosswalk.pdf Supplementary Document	2025-11-19
Responses to Public Comments.docx Supplementary Document	2025-11-19
NonResponseLetterFraud.pdf Supplementary Document	2025-11-19
HCStatementGPLetter.pdf Supplementary Document	2025-11-19
FacThankYouLetter.pdf Supplementary Document	2025-11-19
FacPrepInterviewLetter.pdf Supplementary Document	2025-11-19
FacAdvLetterBillOffices.pdf Supplementary Document	2025-11-19
ComLanguageInsert.pdf Supplementary Document	2025-11-19
BaseThankYouLetter.pdf Supplementary Document	2025-11-19
BaseFAQEnclosure.pdf Supplementary Document	2025-11-19
MCBSFAQ.pdf Supplementary Document	2025-11-19
ComAdvLetterCallUs.pdf Supplementary Document	2025-11-19
CMSThankYouLetter.pdf Supplementary Document	2025-11-19
ReminderPostcard.pdf Supplementary Document	2025-11-19
ReminderLetter.pdf Supplementary Document	2025-11-19
NonResponseLetter.pdf Supplementary Document	2025-11-19
IncomeandAssetsBrochure.pdf Supplementary Document	2025-11-19
RedesignedComBrochure.pdf Supplementary Document	2025-11-19
MCBSCommunityBrochure.pdf Supplementary Document	2025-11-19
ComAuthLetter.pdf Supplementary Document	2025-11-19
ComAdvLetterContactYou.pdf Supplementary Document	2025-11-19
MCBS Facility Brochure.pdf Supplementary Document	2025-11-19
FacAdvanceLetter.pdf Supplementary Document	2025-11-19
Attachment 6. CAPI screenshots.pdf Supplementary Document	2025-11-19
NextofKinForm.pdf Supplementary Document	2025-11-19
ResConsentForm.pdf Supplementary Document	2025-11-19
HIPAALetter.pdf Supplementary Document	2025-11-18
MCBSCalendar.pdf Supplementary Document	2025-11-18
MCBSRespondentNewsletter.pdf Supplementary Document	2025-11-18

IC Document Collections

IC ID	Document Title	Status
8171	Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) Form	Modified

ICR Details

OMB Control No: 0938-0568	ICR Reference No: 202511-0938-005
Status: Received in OIRA	Previous ICR Reference No: 202504-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: OEDA
Title: Medicare Current Beneficiary Survey (MCBS) (CMS-P-0015A)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/21/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2027
Responses	35,015	35,015
Time Burden (Hours)	32,258	35,206
Cost Burden (Dollars)	0	0

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Abstract: The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a nationally representative sample of aged, disabled, and institutionalized Medicare beneficiaries. MCBS, which is sponsored by the Centers for Medicare & Medicaid Services (CMS), is the only comprehensive source of information on the health status, health care use and expenditures, health insurance coverage, and socioeconomic and demographic characteristics of the entire spectrum of Medicare beneficiaries. The purpose of this revision is to seek approval for CMS to add new items on sleep apnea, thyroid disease, and bowel disease, remove content that is no longer relevant to the goals of the survey, and update existing content to better meet the policy needs of CMS and stakeholders. To ensure the sustainability of the survey and to maintain a reasonable level of respondent burden, it is necessary to routinely review MCBS survey content and remove items that are no longer as relevant to the policy landscape or which are no longer performing well. The requested deletions are a result of a content reduction process that CMS developed in 2024 and is currently using to review MCBS survey content in the Community and Facility instruments. The goals of this process are three-fold: 1) to promote efficiency by streamlining the questionnaire and reducing respondent burden; 2) to continuously assess utility of information collected by the MCBS and remove questions that are no longer relevant, and 3) to maintain the production of high-quality data by removing content that is no longer performing well. For this full clearance revision, CMS has used the content reduction process to identify items that a) are low performing due to difficulty of administration or data quality issues, b) are no longer needed at the same frequency of administration, c) require updated question text or response options, or d) no longer match the existing healthcare landscape or require further evaluation.

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Authorizing Statute(s): PL: Pub.L. 108 - 173 723 Name of Law: Medicare Prescription Drug, Improvement, and Modernization Act
   PL: Pub.L. 111 - 148 3021 Name of Law: Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 31207	07/14/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 52675	11/21/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A, CMS-P-0015A	Cost Payment Summary ,   Demographic Income ,   End Questionaire ,   Enumeration Summary ,   Mobility of Beneficiaries ,   Post Statement Cost ,   Access to Care ,   Chronic Pain ,   Dental, Vision, and Hearing Care Utilization ,   Drug Coverage ,   Emergency Utilization ,   Health Insurance ,   Home Health ,   Housing_Characteristics ,   Income_and_ Assets ,   Inpatient Utilization ,   Institutional Utilization ,   Introduction ,   Medical Provider Utilzation ,   Nicotine Alcohol ,   No Statement Cost ,   Other Medical Expense ,   Outpatient Utilization ,   Prescribed Medicine Utilization ,   Satisfaction Care ,   Statement Cost Series ,   Beneficiary Knowledge ,   Preventive Care ,   Usual Source of Care ,   Showcards and Reference Cards ,   Facility Showcards ,   Facility Screener ,   Residence History Missing Data ,   Residence History ,   Health_Status ,   Background_Questionnaire ,   Background_Questionnaire MIssing Data ,   Expenditures ,   Questionaire Missing Data ,   Questionaire ,   Health_Insurance ,   Cognitive Measures ,   HFQ - Health Status and Functioning ,   Use of Health Services Section Specifications ,   Telemedicine Questionnaire ,   Immunization ,   Health_Status ,   Interviewer_Remarks ,   Debt Questionaire

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	35,015	35,015	0	0	0	0
Annual Time Burden (Hours)	32,258	35,206	0	-2,948	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden has decreased due to the removal of 209 items and the revision of 46 items. As a result, the total burden has decreased from 35,206 in the currently approved clearance to 32,258. This is a net decrease of 2,948 burden hours annually.

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Annual Cost to Federal Government: $22,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/21/2025

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