Provider Based and Excluded Unit Reviews

Home Provider Part A Medicare Areas Provider Based and Excluded Unit Reviews

Provider Based

NOTE: Do not submit your provider-based attestation until an 855 application for your additional location has been submitted. Review on the provider-based attestation CANNOT begin until the corresponding 855 application has been received.

NOTE: Do not submit your provider-based attestation unless all of the necessary information is included and/or available. For example, if you have not included a copy of the license showing that the main and provider-based facility are operated under the same license, or support showing that your state does not allow this, a missing information letter will be issued requesting such information. If the request is not met within 30 days, the provider-based attestation must be recommended for denial due to missing information per Change Request 2411, issued April 18, 2003. To avoid such a denial you should hold off on submitting the attestation until all information is available.

Instructions and Regulations

Definitions

Provider Based PM A-03-030

Attestation and Self Reporting

Contact Information

Denials/Appeal Rights

Attestation Forms

Excluded Unit Reviews

Inpatient Rehabilitation Facility (IRF) Classification Requirements

IRF (75% Rule) Requirements Enforcement Implementation

Page Last Updated: Tuesday, 15-Jul-2008 10:38:01 CDT