Medicare Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (CMS-10931)

Forms and Documents

Document Name	Status
Form CMS-10931 OPPS Drug Acquisition Cost Survey Form and Instruction	Modified
CMS-10931_Supporting Statement - Part B_ODACS.docx Supporting Statement B	2025-11-25
CMS-10931_Supporting Statement - Part A_ODACS.docx Supporting Statement A	2025-11-25
Comments and Responses_ODACS.docx Supplementary Document	2025-11-21

IC Document Collections

IC ID	Document Title	Status
276343	OPPS Drug Acquisition Cost Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0938-1487	ICR Reference No: 202511-0938-014
Status: Received in OIRA	Previous ICR Reference No: 202507-0938-017
Agency/Subagency: HHS/CMS	Agency Tracking No: CCSQ
Title: Medicare Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (CMS-10931)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/25/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	4,500	0
Time Burden (Hours)	362,250	0
Cost Burden (Dollars)	0	0

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Abstract: On April 18, 2025, President Trump signed Executive Order (E.O.) 14273, “Lowering Drug Prices by Once Again Putting Americans First.” Section 5 of the E.O., “Appropriately Accounting for Acquisition Costs of Drugs in Medicare,” directs the Secretary of HHS to publish in the Federal Register a plan to conduct a survey under section 1833(t)(14)(D)(ii) of the Act so he can determine the hospital acquisition cost for covered outpatient drugs at hospital outpatient departments. This survey corresponds to this executive order. The acquisition cost data hospitals submit in response to this survey will be considered when formulating proposed payment rates for drug payment under the Medicare Outpatient Prospective Payment System (OPPS). The respondents of the survey will be the approximately 4,500 hospitals that are paid under the OPPS.

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Authorizing Statute(s): US Code: 42 USC 1833(t)(14)(D)(ii) Name of Law: Payment of benefits
  

Citations for New Statutory Requirements: US Code: 42 USC 1833(t)(14)(D)(ii) Name of Law: Payment of benefits

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV51	Final or interim final rulemaking	90 FR 53448	11/25/2025

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Federal Register Notices & Comments

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
OPPS Drug Acquisition Cost Survey	CMS-10931	OPPS Drug Acquisition Cost Survey

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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	4,500	0	4,500	0	0	0
Annual Time Burden (Hours)	362,250	0	362,250	0	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: No

Burden Reduction Due to:

Short Statement: New collection

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Annual Cost to Federal Government: $2,135,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? No

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: 11/25/2025

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