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OMB Control No: 0938-1429	ICR Reference No: 202601-0938-002
Status: Received in OIRA	Previous ICR Reference No: 202410-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: CCIIO
Title: Transparency in Pricing Information (CMS-10715)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: Yes
Type of Review Request: Regular	Date Submitted to OIRA: 02/12/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2027
Responses	3,162	74,462
Time Burden (Hours)	11,010,787	28,618,546
Cost Burden (Dollars)	0	0

Abstract: The information collection requirements contained in the proposed rule titled “Transparency in Coverage,” published November 27, 2019 (84 FR 65464), would require group health plans and health insurance issuers offering coverage in the individual and group markets to disclose to a participant, beneficiary, or enrollee (or an authorized representative on behalf of such individual), the estimated cost-sharing liability for covered items or services from a particular provider or providers, thereby allowing a participant, beneficiary, or enrollee to obtain an accurate estimate and understanding of their potential out-of-pocket expenses and to effectively shop for covered items and services. Group health plans and health insurance issuers would be required to make such information available through a self-service tool on an internet website. The self-service tool must provide the information through real-time responses and allow users to search for cost-sharing information for covered items and services. The self-service tool must also allow users to input information necessary to learn the out-of-network allowed amount for a covered item or service and have the capability to refine and reorder results. Group health plans and health insurance issuers would also be required to make this information available as a disclosure in written form. Both the self-service tool and the paper disclosure would be required to include several disclaimer statements relevant to information provided through the disclosure and could be provided by using a model notice developed by the Departments. Additionally, group health plans and health insurance issuers would be subject requirements to disclose in-network provider negotiated rates and historical payment data for allowed amounts for covered items and services furnished by out-of-network providers through two digital files in a machine-readable format to be specified by the Departments. The Negotiated Rate file and the Allowed Amount file must be posted publicly on an internet website.

Authorizing Statute(s): US Code: 45 USC 156.220 Name of Law: Transparency in Coverage
   PL: Pub.L. 111 - 148 1311(e)(3) Name of Law: Patient Protection and Affordable Care Act
   US Code: 45 USC 155.1040(a)-(c) Name of Law: Transparency in Coverage

Citations for New Statutory Requirements: US Code: 45 USC 155.1040(a)-(c) Name of Law: Transparency in Coverage
US Code: 45 USC 156.220 Name of Law: Transparency in Coverage

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV64	Proposed rulemaking	90 FR 60432	12/23/2025

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3,162	74,462	-71,300
Annual Time Burden (Hours)	11,010,787	28,618,546	-17,607,759
Annual Cost Burden (Dollars)	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: The overall burden has decreased from 28,618,546 to 11,010,784 hours, resulting in a total burden reduction of approximately -17,607,761 hours. Over the same period, the associated cost has increased from $1,036,852,972 to $1,105,621,876, resulting in a reduction of approximately $68,768,904. Although the 2025 proposed rules introduce new requirements that increase burden, the significant reduction in the overall burden hours is primarily due to removal of first- and second-year one-time burden for issuers and TPAs to develop and implement their internet-based self-service tool, which were incurred in 2022 and 2023. Additionally, the overall reduction in burden is partially driven by updated count of issuers and TPAs, which lowered the total number of affected entities.

Annual Cost to Federal Government: $0

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]? 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

Agency Contact: Jamaa Hill 301 492-4190

Common Form ICR: Yes
Description/Changes for Common Form Usage: The data collections will be used as a common form between HHS, DOL, and Treasury.

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