OMB control number

Home Health Face-to-Face Encounter Clinical Templates (CMS-10564)

OMB 0938-1318 · HHS/CMS.

OMB 0938-1318

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10564 Physician Annual Burden for Completing the Electronic and Paper Clinical Template Form and Instruction
CMS-10564 Supporting Statement Part A - FINAL 11-30-16.docx Supporting Statement A
Revision to Form CMS 10564 Home Health .docx Supplementary Document
Final Responses to HH Template PRA Comments.docx Supplementary Document
Physician Annual Burden for Completing the Electronic and Paper Clinical Template Form and Instruction

All Historical Document Collections

201512-0938-012

2015-12-29