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SUPPLEMENTAL TO FORM CMS-2552-10: WEIGHTED MEDIAN MEDICARE ADVANTAGE ORGANIZATION PAYER-SPECIFIC
NEGOTIATED CHARGE DATA
WORKSHEETS AND INSTRUCTIONS
The Supplemental to Form CMS-2552-10: Weighted Median Medicare Advantage Organization Payer-Specific Negotiated Charge Data results in a
burden of 20 hours.
PROPOSED
WORKSHEET
CURRENTLY
WORKSHEET
APPROVED
NONE
Supplemental to Form CMS-2552-10:
Weighted Median Medicare Advantage
Organization Payer-Specific
Negotiated Charge Data

PAGE #
5 - 28

INSTRUCTIONS
SECTION #
PAGE #
N/A
1-4

REASON FOR THE CHANGE / APPLICATION
OF THE INSTRUCTIONS AND ACCOMPANYING
WORKSHEETS
New worksheet to report payer-specific negotiated
charge data pursuant to the CY 2026 OPPS Proposed
Rule published [INSERT PUBLICATION DATE OF
PROPOSED RULE]

BURDEN
EFFECT
20