How to become medicare certified

how to become medicare certified

Frequently Asked Questions.

How can I become Medicare certified? It depends upon what type of provider you are. If you are a Home Health Agency, Rehab Agency, or CORF, you will need to contact your State Agency for guidance. There are 2 applications: one that will be submitted to the State Agency, and one that will be submitted to your fiscal intermediary. If you are an independent professional, such as a physician, physical therapist, occupational therapist, social worker, or registered dietician, or are part of a group, you would need to contact your local Medicare carrier and submit an application to them. We will be happy to assist you through this process. You may contact us at

Effective 7/1/2009, Speech Language Pathologists are now eligible for independent Medicare provider numbers. Please contact us for more information or for our assistance with your application.

What can I expect to be reimbursed by Medicare? Medicare pays professionals, Rehab Agencies, and CORF’s based on the Medicare fee schedule, which varies according to locality. Home Health Agencies are paid based on their case-mix.

Can I certify a business based from my home? Yes, some professionals, such as physicians, physical and occupational therapists, social workers, and dieticians may obtain Medicare

certification for a business based from home, if you only see patients in their homes. You must maintain private office space in your home used solely for your business office. Additionally, you must make sure that no special permit is required from your city, township, or association to operate a business from your place of residence.

Home Health Agencies, Rehab Agencies, CORF’s, and DME suppliers must have a business office that is zoned for commercial use.

How large does my office need to be to meet Medicare guidelines? CMS does not give specifications as to a minimum office size. However, your office must be large enough to accommodate your expected patient and/or staff volume. For Rehab Agencies and CORF’s, your office must be barrier-free and must have a sink located within your office.

How long will it take to become Medicare certified? Independent professionals, such as physicians and physical therapists, can be approved by Medicare in as little as 6 weeks. For a home health agency, you should plan on at least 10-12 months before you’ll be able to bill for services rendered.Rehab agencies and DME providers in most states should expect to be certified in approximately 6-8 months.

Glossary of Terms.

Minimum services provided:


Category: Insurance

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