Crosswalk

CMS-4201-P Crosswalk 10262022.xlsx

Triennial Network Adequacy Review for Medicare Advantage Organizations and 1876 Cost Plans (CMS-10636)

Crosswalk

OMB: 0938-1346

Document [xlsx]
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Number Form Change Current Location Reason
1 Supporting Statement Added languge to include proposed changes to the provider specialty types collected on HSD tables as part of CMS-4201-P. The new provider specialty types: clincal pyschology, clinical social work and prescribers of medication for Opioid Use Disorder will also be added to the list of telehealth eligible specialty types. Summary of Changes Publication of CMS-4201-P
2 Medicare Advantage Network Adequacy Guidance Added clinical pyschology, clinical social work and Prescribers of Medication for Opioid Use Disorder proposed in CMS-4201-P to the list of collected provider specialty types in appendix A Appendix A
3 Medicare Advantage Network Adequacy Guidance Added clinical pyschology, clinical social work and Prescribers of Medication for Opioid Use Disorder proposed in CMS-4201-P to the list of collected provider specialty types eligible for a telehealth credit 5.5. Telehealth Credit Publication of CMS-4201-P
4 Exception Request Template Added clinical pyschology, clinical social work and Prescribers of Medication for Opioid Use Disorder to the drop-down list of specialty types Part I: Exception Information: Specialty Publication of CMS-4201-P







































































































































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