Home Health Agency Cost Report and Supporting Regulations (CMS-1728-20)

OMB 0938-0022

Form CMS-1728-20 is the form used by Home Health Agencies to report their health care costs to determine the amount of reimbursement for services furnished to Medicare beneficiaries.

The latest form for Home Health Agency Cost Report and Supporting Regulations (CMS-1728-20) expires 2023-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
CMS-1728-20.Supporting_Statement_Part_A.docx Supporting Statement A
Home Health Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, 413.106 Instruction

All Historical Document Collections

202307-0938-008 Approved without change	Reinstatement without change of a previously approved collection	2023-07-21
202002-0938-013 Approved with change	Reinstatement with change of a previously approved collection	2020-02-26
201602-0938-002 Approved with change	Revision of a currently approved collection	2016-02-11
201309-0938-021 Approved without change	Extension without change of a currently approved collection	2013-09-19
201008-0938-024 Approved without change	Extension without change of a currently approved collection	2010-08-31
200704-0938-007 Approved without change	Extension without change of a currently approved collection	2007-04-19
200402-0938-009 Approved without change	Revision of a currently approved collection	2004-02-18
200103-0938-003 Approved without change	Revision of a currently approved collection	2001-03-07
200010-0938-010 Approved without change	Revision of a currently approved collection	2000-10-25
199904-0938-007 Approved without change	Revision of a currently approved collection	1999-04-28
199706-0938-006 Approved without change	Revision of a currently approved collection	1997-06-13
199408-0938-004 Approved without change	Revision of a currently approved collection	1994-08-03
199310-0938-017 Approved without change	Reinstatement with change of a previously approved collection	1993-10-14
199112-0938-002 Approved without change	Revision of a currently approved collection	1991-12-05
199004-0938-007 Approved without change	Reinstatement with change of a previously approved collection	1990-04-27
198704-0938-005 Approved without change	Extension without change of a currently approved collection	1987-04-29
198604-0938-001 Approved without change	Revision of a currently approved collection	1986-04-08
198509-0938-012 Approved without change	Reinstatement with change of a previously approved collection	1985-09-16
198409-0938-009 Approved without change	Revision of a currently approved collection	1984-09-10
198206-0938-008 Approved without change	Revision of a currently approved collection	1982-06-14
198110-0938-004 Approved without change	Revision of a currently approved collection	1981-10-13
198106-0938-013 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-06-09
198106-0938-012 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-06-08
198106-0938-011 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-06-05
198012-0938-005 Approved with change	No material or nonsubstantive change to a currently approved collection	1980-12-05
198011-0938-001 Approved without change	Revision of a currently approved collection	1980-11-05
198006-0938-009 Approved with change	No material or nonsubstantive change to a currently approved collection	1980-06-06
198005-0938-002 Approved without change	Revision of a currently approved collection	1980-05-02
197609-0938-003 Approved without change	Extension without change of a currently approved collection	1976-09-29