Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulation in 42 CFR 485.701-485.729

(CMS-1856) Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulations

OMB: 0938-0065

IC ID: 7822

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Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulation in 42 CFR 485.701-485.729
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 485.701-485.729

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-1856 Request for Certification in the Medicare and/or Medicaid Program Form CMS-1856 (10-02-17)_ 508 compliant.pdf No   Fillable Printable

Health Health Care Services

 

350 300
   
Private Sector Businesses or other for-profits
 
   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 350 0 -350 0 700 0
Annual IC Time Burden (Hours) 88 0 -525 0 613 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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