Information Collection

Home Health Services: Documentation of the Face-to-Face Encounter

IC 222848 under ICR 202301-0938-021 · OMB 0938-1319.

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Information Collection (IC) Details

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IC Title:	Home Health Services: Documentation of the Face-to-Face Encounter	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 440.70(f) and (g)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,495,355	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,495,355	1,351,912	1,143,443
Annual IC Time Burden (Hours)	416,724	225,769	190,955
Annual IC Cost Burden (Dollars)	0	0	0

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