PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Initial and renewal MOC Submissions
Modified
287
1680
0
Form
CMS-10565
Model of Care Matrix Upload Document for Initial Application and Renewal
Off-cycle Submission of Summaries (MOC Changes)
Modified
11
44
0
Form
CMS-10565
Revised Model of Care Matrix Upload Document
Tracking Face-to Face Encounters
New
734
2936
0
Total burden requested under this ICR:
1032
4660
0
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