[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR456.170]



[Page 349-350]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 456_UTILIZATION CONTROL--Table of Contents

 

             Subpart D_Utilization Control: Mental Hospitals

 

Sec.  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 recipient's need for care in 

the hospital; and appropriate professional personnel must make a 

psychiatric and social evaluation.



[[Page 350]]



    (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.