Physician Assistants to Perform SNF Level of Care Certifications and Recertifications

January 2012

MLN Matters® Number: MM7701                         Related Change Request (CR) #: 7701
Related CR Release Date: January 13, 2012           Effective Date: January 1, 2011
Related CR Transmittal #: R76GI and R153BP     Implementation Date: February 13, 2012

Allowing Physician Assistants to Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertifications

Provider Types Affected
SNFs and swing-bed hospitals that bill Medicare contractors (Fiscal Intermediaries (FIs) or A/B Medicare Administrative Contractors (A/B MACs)) for providing Part A SNF services to Medicare beneficiaries are affected.

What Providers Need to Know
This article is based on Change Request (CR) 7701, which implements Section 3108 of the Affordable Care Act.  This section adds physician assistants to the list of practitioners who can perform SNF level of care certifications and recertifications.  Performing this function is a requirement for Medicare coverage of SNF services under Part A.

CR7701 directs Medicare contractors to recognize that, effective with services furnished on or after January 1, 2011, physician assistants can perform the required initial certification and periodic recertifications of a beneficiary’s need for a SNF level of care.