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Outpatient Rehabilitation Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24

IC 7791 under ICR 200711-0938-012 · OMB 0938-0037.

Documents and Forms
Document Name
Document Type
Form
Instruction
Instruction
Instruction
Instruction
Form
Information Collection (IC) Details

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Outpatient Rehabilitation Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
 
No Modified
 
Mandatory
 
42 CFR 413.24 42 CFR 413.20

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-2088-92 Cost Report CMS-2088-92.XLS Yes Yes Paper Only
Instruction CMS-2088-92 pr2_18_toc.doc Yes Yes Paper Only
Instruction CMS-2088-92 pr2_1800_to_1816.6.doc Yes Yes Paper Only
Instruction CMS-2088-92 pr2_1890.doc Yes Yes Paper Only
Instruction CMS-2088-92 pr2_1895.doc Yes Yes Paper Only

Health Health Care Services

 

623 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 623 0 0 5 0 618
Annual IC Time Burden (Hours) 62,300 0 0 500 0 61,800
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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