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Face-to-Face encounter, physician's burden for form completion, Documenting Date of Certification 424.22 (annual)

IC 195704 under ICR 201703-0938-017 · OMB 0938-1083.

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Face-to-Face encounter, physician's burden for form completion, Documenting Date of Certification 424.22 (annual)
 
No Unchanged
 
Mandatory
 
42 CFR 424.22(a)(1)(v)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

11,968 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  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 830,287 0 -2,096,133 0 0 2,926,420
Annual IC Time Burden (Hours) 13,783 0 -230,085 0 0 243,868
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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