Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms

OMB 0938-0952

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10130 Federal Funding of Emergency Health Services (Section 1011) Provider Payment Determination (CMS-10130A) Form and Instruction
Form CMS-10130 Federal Funding of Emergency Health Services;Request for Section 1011 Hospital On-call Payments to Physicians (CMS-10130B) Form and Instruction
CMS 10130 - Supporting_Statement_Part A [rev 7-19-2013 by OSORA PRA].doc Supporting Statement A
Federal Funding of Emergency Health Services (Section 1011) Provider Payment Determination (CMS-10130A) Form and Instruction
Federal Funding of Emergency Health Services;Request for Section 1011 Hospital On-call Payments to Physicians (CMS-10130B) Form and Instruction