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REG-120692-09 (TD XXXX-temp)- Notice of Medical Necessity Criteria under the Mental Health Parity and Addition Equity Act of 2008

IC 191315 under ICR 201210-1545-001 · OMB 1545-2165.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2165 can be found here:

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Information Collection (IC) Details

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IC Title:	REG-120692-09 (TD XXXX-temp)- Notice of Medical Necessity Criteria under the Mental Health Parity and Addition Equity Act of 2008	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 26 CFR 54.9812-1T

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 424,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 38 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	223,200	223,200	0	0	0	0
Annual IC Time Burden (Hours)	1,900	1,900	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.