Review Choice Demonstration for Inpatient Rehabilitation Facility Services

Pre-Claim Review Demonstration for Inpatient Rehabilitation Facility Services (CMS-10765)

OMB: 0938-1420

IC ID: 249216

Documents and Forms

Document Name Document Type
Form CMS-10765 Review Choice Demonstration for Inpatient Rehabilitation Facility Services Form and Instruction
CMS-10765 Review Choice Demonstration for Inpatient Rehabilitation CMS-10765 - IRF Instrument.docx Form and Instruction
CMS-10765 Review Choice Demonstration for Inpatient Rehabilitation CMS-10765 - IRF Instrument.docx Form and Instruction