View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Telehealth Remote Patient Monitoring	Agency IC Tracking Number:	2900-0876 Telehealth Remote Patient Monitoring

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2900-0876 Telehealth Remote Patient Monitoring	2900-0876 Telehealth Remote Patient Monitoring	Wireframe Remote Patient Monitoring - Home Telehealth New.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Department of Veterans Affairs (VA)	FR Citation: 86 FR 6992

Number of Respondents: 50,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	50,000	0	50,000	0	0	0
Annual IC Time Burden (Hours)	3,333	0	3,333	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Telehealth Remote Patient Monitoring	A11 Fast-Track Clarance Request Template_Telehealth RPM-HT.docx	09/16/2025

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.