Medicare Participating Physician or Supplier Agreement

Medicare Participating Physician or Supplier Agreement

OMB: 0938-0373

IC ID: 8015

Information Collection (IC) Details

View Information Collection (IC)

Medicare Participating Physician or Supplier Agreement
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-460 Medicare Participating Provider or Supplier Agreement CMS-460-n.pdf Yes No Fillable Fileable

Health Health Care Services

 

29,000 0
   
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 29,000 0 0 -91,000 0 120,000
Annual IC Time Burden (Hours) 7,250 0 0 -22,750 0 30,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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