42 CFR § 456.160 - Certification and recertification of need for inpatient care.
---
identifier: "/us/cfr/t42/s456.160"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 456.160 - Certification and recertification of need for inpatient care."
title_number: 42
title_name: "Public Health"
section_number: "456.160"
section_name: "Certification and recertification of need for inpatient care."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "C"
subchapter_name: "MEDICAL ASSISTANCE PROGRAMS"
part_number: "456"
part_name: "UTILIZATION CONTROL"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302."
regulatory_source: "43 FR 45266, Sept. 29, 1978, unless otherwise noted."
cfr_part: "456"
---
# 456.160 Certification and recertification of need for inpatient care.
(a) *Certification.* (1) A physician must certify for each applicant or beneficiary that inpatient services in a mental hospital are or were needed.
(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.
(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.
(2) Recertification must be made at least every 60 days after certification.
[46 FR 48561, Oct. 1, 1981]