Information Collection

Medicare Credit Balance Reporting Requirements and Supporting Regulations in 42 CFR 405.371, 405.378, and 413.20

IC 8203 under ICR 199908-0938-005 · OMB 0938-0600.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0600 can be found here:

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Information Collection (IC) Details

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IC Title:	Medicare Credit Balance Reporting Requirements and Supporting Regulations in 42 CFR 405.371, 405.378, and 413.20	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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-838				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 47,600	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	190,400	40,000	150,400
Annual IC Time Burden (Hours)	1,142,400	240,000	902,400
Annual IC Cost Burden (Dollars)	0	0	0

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