OMB control number

Supplemental to Form CMS-2552-10: Weighted Median Medicare Advantage Organization Payer- Specific Negotiated Charge Data (CMS-10935)

OMB 0938-1486 · HHS/CMS.

OMB 0938-1486

Respondents participating in the Medicare program use Supplemental to Form CMS-2552-10: Median Payer-Specific Negotiated Charge Data Worksheet to report payer-specific negotiated charge data pursuant to the CY 2026 OPPS Final Rule (CMS-1834-FC) published November 25, 2025. This supplemental form advances the policy goal of increasing healthcare price transparency and promoting market-based approaches in Medicare FFS payments. The form requires hospitals to report, by MS-DRG, the weighted median of the payer-specific charges negotiated with Medicare Advantage organizations. The information reported on the worksheet enables CMS to calculate new IPPS MS-DRG relative weights beginning in FY 2029 and reinforces the administration's commitment to clear, accurate, and actionable healthcare pricing information.

The latest form for Supplemental to Form CMS-2552-10: Weighted Median Medicare Advantage Organization Payer- Specific Negotiated Charge Data (CMS-10935) expires 2029-01-31 and can be found here.