(CMS-1856) Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulations

OMB 0938-0065

The Medicare Program surveys providers of outpatient physical therapy and sppech-language patholgy services to determine compliance with Federal Regulations. The request for certification form is used by State Agency surveyors to determine if minimum Medicare eligibility requirements are met. The survey report form records the result of the on-site survey.

The latest form for (CMS-1856) Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulations expires 2021-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-1856 Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulation in 42 CFR 485.701-485.729 Form and Instruction
CMS-1856 Response_to_Public_Comments 8-6-21.docx Supplementary Document
CMS-1856 Supporting Statement (CLEAN 6-1-21).docx Supporting Statement A
Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulation in 42 CFR 485.701-485.729 Form and Instruction

All Historical Document Collections

202108-0938-005 Approved without change	Extension without change of a currently approved collection	2021-08-13
201805-0938-014 Approved without change	Reinstatement with change of a previously approved collection	2018-05-22
201408-0938-005 Approved without change	Revision of a currently approved collection	2014-08-28
201106-0938-020 Approved without change	Extension without change of a currently approved collection	2011-06-21
200809-0938-007 Approved without change	Extension without change of a currently approved collection	2008-09-04
200509-0938-013 Approved without change	Extension without change of a currently approved collection	2005-09-19
200208-0938-014 Approved without change	Extension without change of a currently approved collection	2002-08-29
199907-0938-002 Approved without change	Reinstatement without change of a previously approved collection	1999-07-01
199603-0938-006 Approved without change	Reinstatement with change of a previously approved collection	1996-03-20
199205-0938-003 Approved without change	Revision of a currently approved collection	1992-05-28
199111-0938-001 Approved without change	Revision of a currently approved collection	1991-11-21
198907-0938-005 Approved without change	Reinstatement with change of a previously approved collection	1989-07-13
198904-0938-017 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-04-03
198708-0938-013 Approved with change	No material or nonsubstantive change to a currently approved collection	1987-08-07
198605-0938-002 Approved without change	Revision of a currently approved collection	1986-05-06
198406-0938-005 Approved without change	Reinstatement with change of a previously approved collection	1984-06-25
198212-0938-013 Disapproved and continue	Revision of a currently approved collection	1982-12-15
198204-0938-010 Approved without change	Reinstatement with change of a previously approved collection	1982-04-02
198107-0938-017 Approved with change	No material or nonsubstantive change to a currently approved collection	1981-07-28
198102-0938-018 Approved without change	Reinstatement with change of a previously approved collection	1981-02-27
198006-0938-003 Approved without change	Reinstatement with change of a previously approved collection	1980-06-09
197803-0938-015 Approved with change	No material or nonsubstantive change to a currently approved collection	1978-03-29
197710-0938-006 Approved without change	Revision of a currently approved collection	1977-10-03
197709-0938-003 Not subject to PRA and continue	Revision of a currently approved collection	1977-09-13
197412-0938-004 Approved without change	Revision of a currently approved collection	1974-12-16