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[Medicaid] GenIC #43 (Revised): Certified Community Behavioral Health Clinic (CCBHC) Cost Report CMCS
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 #43 CCBHC Cost Report ccbhc-cost-report-2024-02-12-final 508.xlsx Yes Yes Fillable Fileable
Instruction revised_ccbhc-cost-report-instruction 508.pdf Yes No Printable Only

Health Health Care Services

 

60 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 60 0 60 0 0 0
Annual IC Time Burden (Hours) 3,390 0 3,390 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement GenIC #43 - Generic Supporting Statement (2023 version 9).docx 02/14/2024
Track Change: CCBHC Cost Report DRAFT_ccbhc-cost-report-2024-01-30 - Redlined.xlsx 02/14/2024
Track Change: CCBHC Cost Report Instructions DRAFT_revised_ccbhc-cost-report-instruction_redline.docx 02/14/2024
Cost Report Elements Crosswalk 43 -Cost Report Elements Crosswalk for States 12.6.23 updates.pdf 02/14/2024
Response to Public Comments Response to Comments_2-14-24.docx 02/14/2024
Public Comment: NYS Office of Mental Health lrq-vrvu-t6jq - Comment.docx 02/14/2024
Public Comment: Daniel Kindler lrq-t2w5-z9dd - Cover Info and Comment.pdf 02/14/2024
Public Comment: Myers and Stauffer, LC lrq-i6xj-a3nh - Cover Info and Comment.pdf 02/14/2024
Public Comment: Illinois Department Healthcare and Family Services Illinois Department Healthcare and Family Services.docx 02/14/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.