View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0938-0065	ICR Reference No: 201408-0938-005
Status: Historical Active	Previous ICR Reference No: 201106-0938-020
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: (CMS-1893/1856) Outpatient Physical Therapy Speech Pathology Survey Report and Supporting Regulations
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/24/2014
	Date Received in OIRA: 08/28/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2017	36 Months From Approved	11/30/2014
Responses	700	0	495
Time Burden (Hours)	613	0	866
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	700	495	205
Annual Time Burden (Hours)	613	866	-253
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The frequency of use of these forms has decreased in recent years. The estimated annual number of respondents has changed. The annual burden hours has decreased from 866 to 613.

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