Provider-Based Attestations

Effective October 1, 2002, the mandatory requirement for provider-based determinations under §413.65(b) has been replaced with a voluntary attestation process. The Fiscal Intermediary (FI)/Medicare Administrative Contractor (MAC) is responsible for ensuring all information is submitted to make a sound recommendation to CMS. Providers are no longer required to apply for and receive a provider-based determination for their facilities prior to billing for services in those facilitates as provider-based.

However, under §413.65(b)(3), a provider may choose to obtain a determination of provider-based status in certain situations by submitting an attestation stating that the facility meets the relevant provider-based requirements (depending on whether the facility is located on campus or off campus). Providers who wish to obtain such a determination of provider-based status for their facilities after October 1, 2002 should do so through the self-attestation process.

In order to facilitate the review process and avoid any unnecessary submissions, please read through the below frequently asked questions before submitting an attestation to WPS.

Provider-Based Attestations FAQs
Provider Based PM A-03-030Adobe Portable Format document
Definitions
Attestation Forms
Denials/Appeal Rights

Page Last Updated: Thursday, 15-Dec-2011 14:56:29 CST