DIRECT DEALING LETTER NO. 301-BILLING FOR PHYSICAL THERAPY SERVICES

ICR 198309-0938-006

OMB: 0938-0186

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0938-0186 198309-0938-006
Historical Active 198108-0938-012
HHS/CMS
DIRECT DEALING LETTER NO. 301-BILLING FOR PHYSICAL THERAPY SERVICES
Revision of a currently approved collection   No
Regular
Approved without change 11/17/1983
Retrieve Notice of Action (NOA) 09/20/1983
  Inventory as of this Action Requested Previously Approved
09/30/1984 09/30/1984 09/30/1983
5,249 0 3,480
875 0 580
0 0 0

REQUESTED INFORMATION SUPPORTS MEDICARE CLAIM FOR PHYSICAL THERAPY SERVICES FURNISHED BY HOME HEALTH AND PHYSICAL THERAPY AGENCIES RENDERED TO INPATIENTS.

None
None


No

1
IC Title Form No. Form Name
DIRECT DEALING LETTER NO. 301-BILLING FOR PHYSICAL THERAPY SERVICES HCFA-298

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,249 3,480 0 0 1,769 0
Annual Time Burden (Hours) 875 580 0 0 295 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/20/1983


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