Form CMS-10611 MOON Form
Medicare Outpatient Observation Notice (MOON) (CMS-10611)
CMS-10611 MOON_2022_v508_OSORA
Medicare Outpatient Observation Notice
OMB: 0938-1308
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1308 can be found here:
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