Pre-Claim Review Demonstration for Inpatient Rehabilitation Facility Services (CMS-10765)

OMB 0938-1420

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10765 Review Choice Demonstration for Inpatient Rehabilitation Facility Services Form and Instruction
CMS-10765 - Supporting Statement.docx Supporting Statement A
CMS-10765 - Attachment A - Response to Comments - 60-day).docx Supplementary Document
Review Choice Demonstration for Inpatient Rehabilitation Facility Services Form and Instruction

All Historical Document Collections

202507-0938-027	Reinstatement without change of a previously approved collection	2025-07-31
202109-0938-007 Approved without change	New collection (Request for a new OMB Control Number)	2021-09-08