Certification and Recertification Requirements

30.2.1 - Certification and Recertification Requirements (Rev. 253, Issued: 12- 14-18, Effective: 01-16-19, Implementation: 01- 16-19) Medicare Part A pays for inpatient services in an inpatient psychiatric facility only if a physician certifies and recertifies the need for services consistent with the requirements given in Pub. 100-01, Medicare General Information, Eligibility and Entitlement Manual, chapter 4, §10.9, for certification requirements. The format of all certifications and recertifications and the method by which they are obtained is determined by the individual facility. No specific procedures or forms are required. The provider may adopt any method that permits verification of all the IPFs requirements to continue treatment. For example, the recertification may be entered on provider generated forms, in progress notes, or in the records (relating to the stay in question) and must be signed by a physician. Claim denials may not be made for failure to use a certification or recertification form or failure to use particular language or format, provided that the medical record demonstrates the content requirements given at §30.2.1 are met.