{"data":{"id":"us/42-cfr-456.160","jurisdiction":"us","citation":"42 CFR 456.160","heading":"Certification and recertification of need for inpatient care.","body":"(a) Certification. (1) A physician must certify for each applicant or beneficiary that inpatient services in a mental hospital are or were needed.\n(2) The certification must be made at the time of admission or, if an individual applies for assistance while in a mental hospital, before the Medicaid agency authorizes payment.\n(b) Recertification. (1) A physician, or physician assistant or nurse practitioner (as defined in § 491.2 of this chapter) acting within the scope of practice as defined by State law and under the supervision of a physician, must recertify for each applicant or beneficiary that inpatient services in a mental hospital are needed.\n(2) Recertification must be made at least every 60 days after certification.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS","PART 456—UTILIZATION CONTROL","Subpart D—Utilization Control: Mental Hospitals"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"f2f194a784bcc8585179637be0e9216fda5dc0f11401794b400fb59a65541ea9","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-456.151","next":"us/42-cfr-456.170"},"notice":"GroundRules: Original legal text. Not legal advice."}