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OMB Control No: 0938-1311	ICR Reference No: 202509-0938-019
Status: Received in OIRA	Previous ICR Reference No: 202205-0938-011
Agency/Subagency: HHS/CMS	Agency Tracking No: CPI
Title: Pre-Claim Review Demonstration For Home Health Services (CMS-10599)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 09/22/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2025
Responses	3,177,716	2,688,139
Time Burden (Hours)	1,600,608	1,357,224
Cost Burden (Dollars)	74,047,943	2,675,200

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	3,177,716	2,688,139	489,577
Annual Time Burden (Hours)	1,600,608	1,357,224	243,384
Annual Cost Burden (Dollars)	74,047,943	2,675,200	71,372,743

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Due to the addition of a sixth state and an increase in the annual clerical hourly rate and loaded rate, the burden estimate has increased from $26.9 million to $33.8 million for the initial demonstration states and from $49.1 million to $74 million for all 16 states.

Annual Cost to Federal Government: $88,700,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Malcolm Wilson 667 414-0087 malcolm.wilson@cms.hhs.gov