OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Home Health Agency Cost Report and Supporting Regulations (CMS-1728-20)

OMB 0938-0022 · HHS/CMS.

OMB 0938-0022

Form CMS-1728-20 is the form used by Home Health Agencies to report their health care costs to determine the amount of reimbursement for services furnished to Medicare beneficiaries.

The latest form for Home Health Agency Cost Report and Supporting Regulations (CMS-1728-20) expires 2027-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Supporting Statement A
All Historical Document Collections
Approved without change
 Reinstatement without change of a previously approved collection 2023-07-21
Approved with change
 Reinstatement with change of a previously approved collection 2020-02-26
Approved with change
 Revision of a currently approved collection 2016-02-11
Approved without change
 Extension without change of a currently approved collection 2013-09-19
Approved without change
 Extension without change of a currently approved collection 2010-08-31
Approved without change
 Extension without change of a currently approved collection 2007-04-19
Approved without change
 Revision of a currently approved collection 2004-02-18
Approved without change
 Revision of a currently approved collection 2001-03-07
Approved without change
 Revision of a currently approved collection 2000-10-25
Approved without change
 Revision of a currently approved collection 1999-04-28
Approved without change
 Revision of a currently approved collection 1997-06-13
Approved without change
 Revision of a currently approved collection 1994-08-03
Approved without change
 Reinstatement with change of a previously approved collection 1993-10-14
Approved without change
 Revision of a currently approved collection 1991-12-05
Approved without change
 Reinstatement with change of a previously approved collection 1990-04-27
Approved without change
 Extension without change of a currently approved collection 1987-04-29
Approved without change
 Revision of a currently approved collection 1986-04-08
Approved without change
 Reinstatement with change of a previously approved collection 1985-09-16
Approved without change
 Revision of a currently approved collection 1984-09-10
Approved without change
 Revision of a currently approved collection 1982-06-14
Approved without change
 Revision of a currently approved collection 1981-10-13
Approved with change
 No material or nonsubstantive change to a currently approved collection 1981-06-09
Approved with change
 No material or nonsubstantive change to a currently approved collection 1981-06-08
Approved with change
 No material or nonsubstantive change to a currently approved collection 1981-06-05
Approved with change
 No material or nonsubstantive change to a currently approved collection 1980-12-05
Approved without change
 Revision of a currently approved collection 1980-11-05
Approved with change
 No material or nonsubstantive change to a currently approved collection 1980-06-06
Approved without change
 Revision of a currently approved collection 1980-05-02
Approved without change
 Extension without change of a currently approved collection 1976-09-29