States adoption of Healthcare Common Procedure Coding System codes (H0049) and (H0050) and assessment of support provided by the Centers for Medicare & Medicaid Services

OMB 3201-0015

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 HCPCS Alcohol and Drug Screening and Brief Intervention Survey Form and Instruction
Supporting Statement B - HCPCS.doc Supporting Statement B
Supporting Statement A - HCPCS.doc Supporting Statement A
HCPCS Alcohol and Drug Screening and Brief Intervention Survey Form and Instruction

All Historical Document Collections

200807-3201-001 Approved without change	New collection (Request for a new OMB Control Number)	2008-07-31
200805-3201-001 Improperly submitted	New collection (Request for a new OMB Control Number)	2008-06-25