US · guidance
CMS Pub. 100-02, ch. 2, § 30.3.2
Services Expected to Improve the Condition or for Purpose of
Diagnosis
(Rev. 253, Issued: 12- 14-18, Effective: 01-16-19, Implementation: 01- 16-19)
In accordance with 42 CFR 424.14(b)(1) and 42 CFR 424.14(c)(1), the physician must
include in all certifications and recertifications that the services provided could
reasonably be expected to improve the patient's condition or are for the purpose of
diagnostic study. It is not necessary that a course of therapy have as its goal the
restoration of the patient to a level which would permit discharge from the institution
although the treatment must, at a minimum, be designed both to reduce or control the
patient's psychotic or neurotic symptoms that necessitated hospitalization and improve
the patient's level of functioning.
History
(Rev. 253, Issued: 12- 14-18, Effective: 01-16-19, Implementation: 01- 16-19)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7cf64b00bec313e8ade8c64210508794120d9f4e3401d75fa54521984c08e431
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