US · guidance
CMS Pub. 100-06, ch. 6, § 430.6
Completing Lines Eighteen Through Twenty-Two - Reason for Return
B3-13430.6
Line 18 - Incomplete - The number of applications returned to the applicant because the
application was incomplete.
Line 19 - Unverifiable Information - The number of applications returned to the applicant
because the application included unverifiable information.
Line 20 - Not Signed - The number of applications returned to the applicant because the applicant
did not sign the certification statement.
Line 21 - Invalid Billing Agreement - The number of applications returned to the applicant
because the billing agreement did not meet CMS requirements.
Line 22 - Other - The number of applications returned to the applicant for any reason other than
the ones indicated on lines 18 through 21.
History
(Rev. 6, 08-30-02)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a47c27ba1dfb12d677cc8a105208541aa3e4a39180bf6ca7485020c59be441c4
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