42 CFR § 441.480 - Use of a representative.
---
identifier: "/us/cfr/t42/s441.480"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 441.480 - Use of a representative."
title_number: 42
title_name: "Public Health"
section_number: "441.480"
section_name: "Use of a representative."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "C"
subchapter_name: "MEDICAL ASSISTANCE PROGRAMS"
part_number: "441"
part_name: "SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302."
regulatory_source: "43 FR 45229, Sept. 29, 1978, unless otherwise noted."
cfr_part: "441"
---
# 441.480 Use of a representative.
(a) States may permit participants to appoint a representative to direct the provision of self-directed PAS on their behalf. The following types of representatives are permissible:
(1) A minor child's parent or guardian.
(2) An individual recognized under State law to act on behalf of an incapacitated adult.
(3) A State-mandated representative, after approval by CMS of the State criteria, if the participant has demonstrated, after additional counseling, information, training or assistance, the inability to self-direct PAS.
(b) A person acting as a representative for a participant receiving self-directed PAS is prohibited from acting as a provider of self-directed PAS to the participant.