(CMS-381) Extension Locations of Medicare Approved Providers of Outpatient Physical Therapy and Speech-Language Pathology (OPT) Services

ICR 202101-0938-005

OMB: 0938-0273

Federal Form Document

ICR Details
0938-0273 202101-0938-005
Received in OIRA 201710-0938-005
HHS/CMS CCSQ
(CMS-381) Extension Locations of Medicare Approved Providers of Outpatient Physical Therapy and Speech-Language Pathology (OPT) Services
Revision of a currently approved collection   No
Regular 01/14/2021
  Requested Previously Approved
36 Months From Approved 01/31/2021
443 2,161
111 540
0 0

Medicare approved providers of Outpatient Physical Therapy and Speech Pathology Services (OPT) may provide services at additional locations in addition to their Medicare approved primary site. These additional locations are called “extension locations” and must be reported by the provider and approved by CMS. Form CMS-381 provides a method for OPT providers to meet this reporting requirement.

None
None

Not associated with rulemaking

  85 FR 68884 11/19/2020
86 FR 3158 01/14/2021
No

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 443 2,161 0 0 -1,718 0
Annual Time Burden (Hours) 111 540 0 0 -429 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
We have decreased the time burden for this data collection from 540 hours to 111 hours. This is a 429 hour decrease in the time burden. We have also decreased the cost burden associated with this data collection from $49,248 to $1,561.77. This is a $47,686.23 decrease in the cost burden for this data collection.

$173
No
    No
    No
No
No
No
No
Denise King 410 786-1013 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/14/2021


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