Attending Physician's Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations 42 CFR 410.38 and 42 CFR 424.5

Attending Physician's Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations 42 CFR 410.38 and 42 CFR 424.5

OMB: 0938-0534

IC ID: 8145

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Attending Physician's Certification of Medical Necessity for Home Oxygen Therapy and Supporting Regulations 42 CFR 410.38 and 42 CFR 424.5
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 410.38 42 CFR 424.5

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-484 Oxygen CMN CMS-484 CMN FORM.pdf Yes No Fillable Fileable Signable

Health Health Care Services

 

15,000 0
   
Private Sector Businesses or other for-profits
 
   90 %

  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 1,632,000 0 0 0 0 1,632,000
Annual IC Time Burden (Hours) 326,400 0 0 -100 0 326,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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