Code of Federal Regulations (Last Updated: October 10, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter C - Medical Assistance Programs |
Part 456 - Utilization Control |
Subpart D - Utilization Control: Mental Hospitals |
Medical, Psychiatric, and Social Evaluations and Admission Review |
§ 456.170 - Medical, psychiatric, and social evaluations.
Latest version.
-
§ 456.170 Medical, psychiatric, and social evaluations.
(a) Before admission to a mental hospital or before authorization for payment, the attending physician or staff physician must make a medical evaluation of each applicant's or beneficiary's need for care in the hospital; and appropriate professional personnel must make a psychiatric and social evaluation.
(b) Each medical evaluation must include -
(1) Diagnoses;
(2) Summary of present medical findings;
(3) Medical history;
(4) Mental and physical functional capacity;
(5) Prognoses; and
(6) A recommendation by a physician concerning -
(i) Admission to the mental hospital; or
(ii) Continued care in the mental hospital for individuals who apply for Medicaid while in the mental hospital.