| Number | Form | Change | Current Location | Reason | 
	
		| 1 | Supporting Statement | Added languge to include proposed changes to the provider specialty types collected on HSD tables as part of CMS-4201-P.  The new provider specialty types: clincal pyschology, clinical social work and prescribers of medication for Opioid Use Disorder will also be added to the list of telehealth eligible specialty types. | Summary of Changes | Publication of CMS-4201-P | 
	
		| 2 | Medicare Advantage Network Adequacy Guidance | Added clinical pyschology, clinical social work and Prescribers of Medication for Opioid Use Disorder proposed in CMS-4201-P to the list of collected provider specialty types in appendix A | Appendix A | 
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		| 3 | Medicare Advantage Network Adequacy Guidance | Added clinical pyschology, clinical social work and Prescribers of Medication for Opioid Use Disorder proposed in CMS-4201-P to the list of collected provider specialty types eligible for a telehealth credit | 5.5. Telehealth Credit | Publication of CMS-4201-P | 
	
		| 4 | Exception Request Template | Added clinical pyschology, clinical social work and Prescribers of Medication for Opioid Use Disorder to the drop-down list of specialty types | Part I: Exception Information: Specialty | Publication of CMS-4201-P | 
	
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