42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

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There are 9 Updates appearing in the Federal Register for 42 CFR 424. View below or at eCFR (GPOAccess)
§ 424.14 Requirements for inpatient services of inpatient psychiatric facilities.
(a) Content of certification and recertification: General considerations. The content requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is often purely custodial and thus not covered under Medicare. The purpose of the statements, therefore, is to help ensure that Medicare pays only for services of the type appropriate for Medicare coverage. Accordingly, Medicare Part A pays for inpatient care in a psychiatric hospital only if a physician certifies and recertifies the need for services consistent with the content of paragraphs (b) or (c) of this section, as appropriate.
(b) Content of certification. Inpatient psychiatric services were required—
(1) For treatment that could reasonably be expected to improve the patient's condition; or
(2) For diagnostic study.
(c) Content of recertification.
(1) Inpatient services furnished since the previous certification or recertification were, and continue to be, required—
(i) For treatment that could reasonably be expected to improve the patient's condition; or
(ii) For diagnostic study; and
(2) The hospital records show that the services furnished were—
(i) Intensive treatment services;
(ii) Admission and related services necessary for diagnostic study; or
(iii) Equivalent services.
(3) The patient continues to need, on a daily basis, active treatment furnished directly by or requiring the supervision of inpatient psychiatric facility personnel.
(d) Timing of certification and recertification.
(1) Certification is required at the time of admission or as soon thereafter as is reasonable and practicable.
(2) The first recertification is required as of the 12th day of hospitalization. Subsequent recertifications are required at intervals established by the UR committee (on a case-by-case basis if it so chooses), but no less frequently than every 30 days.
(e) Other requirements. Psychiatric hospitals must also meet the requirements set forth in § 424.13 (b), (c), (f), and (g).
[53 FR 6634, Mar. 2, 1988, as amended at 71 FR 27087, May 9, 2006; 71 FR 37504, June 30, 2006]

Title 42 published on 2013-10-01

The following are only the Rules published in the Federal Register after the published date of Title 42.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2014-08-01; vol. 79 # 148 - Friday, August 1, 2014
    1. 79 FR 44702 - Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extended Temporary Moratoria on Enrollment of Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Extension of temporary moratoria.
      Effective Date: July 29, 2014.
      42 CFR Part 424

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United States Code

Title 42 published on 2013-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR 424 after this date.

  • 2014-08-01; vol. 79 # 148 - Friday, August 1, 2014
    1. 79 FR 44702 - Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extended Temporary Moratoria on Enrollment of Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Extension of temporary moratoria.
      Effective Date: July 29, 2014.
      42 CFR Part 424