Inpatient Rehabilitation Assessment Instrument and Data Set for PPS for Inpatient Rehabilitation Facilities (CMS-10036)

ICR 202304-0938-017

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0842 can be found here:

Forms and Documents

Document Name	Status
Form CMS-10036 Inpatient Rehabilitation Facility - Patient Assessment Instrument Form and Instruction	Modified
CMS-10036-Supporting-Statement-A-4.2_Changes to 4.1(v10)_clean.docx Supporting Statement A	2023-04-27

IC Document Collections

IC ID	Document Title	Status
210555	Inpatient Rehabilitation Facility - Patient Assessment Instrument Form and Instruction	Modified

ICR Details