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Hospital Wage Index Occupational Mix Survey and Supporting Regulations in 42 CFR, Section 412.64
No Modified
42 CFR 412.64

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_2016_Medicare_Wage_Index_Occupational_Mix_Survey.pdf Yes Yes Fillable Fileable

Health Health Care Services


3,400 0
Private Sector Businesses or other for-profits, Not-for-profit institutions
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,400 0 0 -100 0 3,500
Annual IC Time Burden (Hours) 1,632,000 0 0 -48,000 0 1,680,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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