Shown below are the details for the item you selected from the list.
| Form # |
CMS 1856 |
| Form Title |
Request for Certification in the Medicare and/or Medicaid Program to Provide Outpatient Physical Therapy and/or Speech Pathology Services |
| Revision Date |
12/11/2006 |
| O.M.B. # |
0938-0065 |
| O.M.B. Expiration Date |
10/31/2008 |
| CMS Manual |
N/A |
| Special Instructions |
N/A |
| | | Downloads |
CMS 1856
| | Related Links Inside CMS |
There are no Related Links Inside CMS
| | Related Links Outside CMS |  |
There are no Related Links Outside CMS
|
|
Last Modified Date : 10/21/2008
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