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Federal forms, ICRs, and supporting documents

Information Collection

Information Collection Requirements In Regulation 489.23(b) And (c) (waiver Of Requirements To Bill Non-physician Services On Part A-prospective Payment, Berc-263)

IC 113403 under ICR 198308-0938-005 · OMB 0938-0304.

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INFORMATION COLLECTION REQUIREMENTS IN REGULATION 489.23(B) AND (C) (WAIVER OF REQUIREMENTS TO BILL NON-PHYSICIAN SERVICES ON PART A-PROSPECTIVE PAYMENT, BERC-263)
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-34 No No


    

5 0
   
Private Sector Businesses or other for-profits
 
   0 %

  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 5 0 5 0 0 0
Annual IC Time Burden (Hours) 50 0 50 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.