What are the timeliness requirements for physician certification and recertifications for the need for skilled services?
The Medicare requirements for physician certification are clearly defined in Title 42 of the Code of Federal Regulations (42CFR 424.10, 424.11, and 424.20). In reference to timeliness, 42 CFR, 424.20 (b) and (d), specify the time frames for certifications and for the initial and subsequent recertifications. The certification must be obtained at admission or as soon thereafter as is reasonable and practical. The 1st recertification is required no later than the 14th day of post-hospital SNF care. Subsequent re-certifications are required at least every 30 days after the 1st recertification. A hospital or SNF may provide for obtaining a certification or recertification earlier than required by these regulations, or vary the time frame (within the prescribed outer limits) for different diagnostic or clinical categories. As stated in the 42 CFR, § 424.11 (d) Timeliness (3) “Delayed certification and recertification statements are acceptable when there is a legitimate reason for delay. (Fo
The Medicare requirements for physician certification are clearly defined in Title 42 of the Code of Federal Regulations (42CFR 424.10, 424.11, and 424.20). In reference to timeliness, 42 CFR, 424.20 (b) and (d), specify the time frames for certifications and for the initial and subsequent recertifications. The certification must be obtained at admission or as soon thereafter as is reasonable and practical. The 1st recertification is required no later than the 14th day of post-hospital Skilled Nursing Facility (SNF) care. Subsequent re-certifications are required at least every 30 days after the 1st recertification. A hospital or SNF may provide for obtaining a certification or recertification earlier than required by these regulations, or vary the time frame (within the prescribed outer limits) for different diagnostic or clinical categories. As stated in the 42 CFR, § 424.11 (d) Timeliness (3) “Delayed certification and recertification statements are acceptable when there is a legit
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