42 CFR 456.60
§ 456.60 Certification and recertification of need for inpatient care.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 456.60, § 456.60 Certification and recertification of need for inpatient care, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/206607
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Full text
(a) Certification.
(1) A physician must certify for each applicant or beneficiary that inpatient services in a hospital are or were needed.
(2) The certification must be made at the time of admission or, if an individual applies for assistance while in a hospital, before the Medicaid agency authorizes payment.
(b) Recertification.
(1) A physician, or physician assistant or nurse practitioner (as defined in § 491.2 of this chapter) acting within the scope of practice as defined by State law and under the supervision of a physician, must recertify for each applicant or beneficiary that inpatient services in a hospital are needed.
(2) Recertifications must be made at least every 60 days after certification.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.