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Outpatient Rehabilitation Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
Outpatient Rehabilitation Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
OMB: 0938-0037
IC ID: 7791
OMB.report
HHS/CMS
OMB 0938-0037
ICR 200711-0938-012
IC 7791
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0037 can be found here:
2021-04-13 - Extension without change of a currently approved collection
2017-07-27 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form CMS-2088-92
Outpatient Rehabilitation Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
Form
CMS-2088-92 pr2_18_toc.doc
Instruction
CMS-2088-92 pr2_1800_to_1816.6.doc
Instruction
CMS-2088-92 pr2_1890.doc
Instruction
CMS-2088-92 pr2_1895.doc
Instruction
CMS-2088-92 Cost Report
CMS-2088-92.XLS
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Outpatient Rehabilitation Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
42 CFR 413.24
42 CFR 413.20
Information Collection Instruments:
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
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
623
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:
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
Documents for IC
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.