Home Health Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, 413.106

Home Health Agency Cost Report and Supporting Regulations (CMS-1728-20)

OMB: 0938-0022

IC ID: 7766

Information Collection (IC) Details

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Home Health Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, 413.106
 
No Modified
 
Mandatory
 
42 CFR 413.20 42 CFR 413.24 42 CFR 413.106

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-1728-20 HHA Cost Report CMS-1728-20.HHA Cost Report - 5-20-20.xlsx Yes Yes Fillable Fileable Signable
Instruction CMS-1728-20. Chapter 47 (5-20-20).docx Yes No Printable Only

Health Health Care Services

 

10,139 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 10,139 0 0 -578 10,717 0
Annual IC Time Burden (Hours) 1,977,105 0 -324,448 -131,206 2,432,759 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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