Information Collection

Medicare Program: Complex Medical Review

IC 8829 under ICR 200608-0938-003 · OMB 0938-0969.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0969 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Medicare Program: Complex Medical Review	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 421.405

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,169,683	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,900,000	-24,208	24,208	2,900,000
Annual IC Time Burden (Hours)	966,667	1,678	481,656	483,333
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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