OMB control number
Hospice Facility Cost Report (CMS-1984-14)
OMB 0938-0758 · HHS/CMS.
OMB 0938-0758
The Hospice Cost and Data Report provides for the collection of data from providers for rate evaluations for the Prospective Payment System (PPS). The data is used by CMS to update the PPS as mandated by Congress.
The latest form for Hospice Facility Cost Report (CMS-1984-14) expires 2027-11-30 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
|---|
Supporting Statement A |
CMS 1984-14 PRA-Hospice - Supporting Statement A.docx
Hospice Cost Report and Supporting Regulations in 42 CFR 413.20 and 413.24 All Historical Document Collections
| Extension without change of a currently approved collection | 2024-10-02 | ||
|
Approved without change |
Reinstatement with change of a previously approved collection | 2021-06-10 | |
|
Approved with change |
Reinstatement without change of a previously approved collection | 2017-08-02 | |
|
Approved without change |
Revision of a currently approved collection | 2013-12-06 | |
|
Approved without change |
Extension without change of a currently approved collection | 2010-11-02 | |
|
Approved without change |
Extension without change of a currently approved collection | 2007-11-15 | |
|
Approved without change |
Extension without change of a currently approved collection | 2004-11-30 | |
|
Approved without change |
Extension without change of a currently approved collection | 2002-01-31 | |
|
Approved without change |
New collection (Request for a new OMB Control Number) | 1999-01-15 |