Psychiatric Unit Criteria Work Sheet, Rehabilitation Unit Criteria Work Sheet, Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations -- 42 CFR 412.20-412.32

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0358 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Psychiatric Unit Criteria Work Sheet, Rehabilitation Unit Criteria Work Sheet, Rehabilitation Hospital Criteria Work Sheet and Supporting Regulations -- 42 CFR 412.20-412.32	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	HCFA-437B	No	No
Form	HCFA-437	No	No
Form	HCFA-437A	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,555	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,555	206	2,349
Annual IC Time Burden (Hours)	639	52	587
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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