Information Collection

The Medicare/Medicaid Psychiatric Hospital Survey Data Contained in 42 CFR and Supporting Regulations in 42 CFR 482.60, 482.61, and 482.62

IC 8018 under ICR 200709-0938-006 · OMB 0938-0378.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0378 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-724 The Medicare/Medicaid Psychiatric Hospital Survey Data Contained in 42 CFR and Supporting Regulations in 42 CFR 482.60, 482.61, and 482.62	Form and Instruction
CMS-724 Mediare/Medicaid Psychiatric Hospital Survey Data CMS-724 Medicare - Medicaid Psychiatric Hospital Survey Data.pdf	Form and Instruction

IC Title:

The Medicare/Medicaid Psychiatric Hospital Survey Data Contained in 42 CFR and Supporting Regulations in 42 CFR 482.60, 482.61, and 482.62

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 482.60-482.62

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-724	Mediare/Medicaid Psychiatric Hospital Survey Data	CMS-724 Medicare - Medicaid Psychiatric Hospital Survey Data.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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