Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Request for Certification in the Medicare and/or Medicaid Program to Provide Outpatient Physical Therapy and/or Speech Pathology Services, Outpatient Physicial Therapy/Speech.... Migrated 255 446 0 Form HCFAA-1893
Form HCFA-1856
Total burden requested under this ICR: 255 446 0  
To view an IC, click on IC Title