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 (CMS-2088-92)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0037 can be found here:

Documents and Forms

Document Name Document Type
2088.92 Manual Instructions.doc Instruction
CMS-2088-92 Outpatient Rehabilitation Provider Cost Report Identific 2088.92 Forms-508.pdf Form

Information Collection (IC) Details

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 42 CFR 410.110

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2088.92 Manual Instructions.doc		Yes	No	Printable Only
Form	CMS-2088-92	Outpatient Rehabilitation Provider Cost Report Identification Data, Certification and Settlement Summary	2088.92 Forms-508.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 540	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	540	-56	596
Annual IC Time Burden (Hours)	54,000	-5,600	59,600
Annual IC Cost Burden (Dollars)	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.