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Proposed Prior Authorization Process and Requirements for Certain Hospital Outpatient Department (OPD) Services (CMS-10711)
ICR 202212-0938-002
OMB: 0938-1368
Federal Form Document
OMB.report
HHS/CMS
OMB 0938-1368
ICR 202212-0938-002
( )
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1368 can be found here:
2024-05-24 - Extension without change of a currently approved collection
Forms and Documents
Document
Name
Status
CMS-10711.Supporting Statement Part A.docx
Supporting Statement A
2022-12-01
IC Document Collections
IC ID
Document
Title
Status
254983
Prior Authorization Process (One New Service Category - Facet Joint Interventions)
Modified
237862
Prior Authorization Process (Five Original Categories)
Modified
ICR Details
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