OMB control number
Pre-Claim Review Demonstration For Home Health Services (CMS-10599)
OMB 0938-1311 · HHS/CMS.
OMB 0938-1311
The Centers for Medicare & Medicaid Services (CMS) is requesting the Office of Management and Budget (OMB) approval for the Pre-Claim Review Demonstration for Home Health Services. This demonstration would help assure that payments for home health services are appropriate before the claims are paid, thereby preventing fraud, waste, and abuse. CMS proposes performing prior authorization before processing claims for home health services in: Florida, Texas, Illinois, Michigan, and Massachusetts.
The latest form for Pre-Claim Review Demonstration For Home Health Services (CMS-10599) expires 2027-12-31 and is listed under ICR 202509-0938-019.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-10599 Home Health Instrument | Form |
| Form CMS-10599 HH Demo Fax and Electronic Submissions and Resubmissions (16 States) | Form |
 CMS-10599 Supporting Statement .docx | Supporting Statement A |
| CMS-10599 Supporting Statement .docx | Supporting Statement A |
 HH Demo - Home Health Agency Education (16 States) |
Instruction |
| HH Demo for Mailed Requests (16 States) |
Instruction |
| HH Demo Fax and Electronic Submissions and Resubmissions (16 States) |
Form |
| HH Demo Fax and Electronic Submissions and Resubmissions (16 States) |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202509-0938-019 | Extension without change of a currently approved collection | 2025-09-22 | ||
| 202205-0938-011 | Reinstatement with change of a previously approved collection | 2022-05-10 | Approved with change | |
| 201810-0938-001 | Revision of a currently approved collection | 2018-10-10 | Approved with change | |
| 201606-0938-007 | New collection (Request for a new OMB Control Number) | 2016-06-24 | Approved with change |
OMB Details
HH Demo Fax and Electronic Submissions and Resubmissions (16 States)
Federal Enterprise Architecture: Health - Health Care Services
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form CMS-10599 | Home Health Instrument | Fillable Fileable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.