OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0938-0022 · HHS/CMS.

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 2027-01-31 and is listed under ICR 202307-0938-008.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
CMS-1728-20.Supporting_Statement_Part_A.docxSupporting Statement A
Home Health Agency Cost Report and Supporting Regulations in 42 CFR 413.20, 413.24, 413.106 Instruction

All Historical Document Collections

Historical document collections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