US · guidance

CMS Pub. 100-04, ch. 32, § 360.1.1

Attending Physician’s Statement and Documentation of Medicare Emergency

activein force · 2026-08-25 – presentas-observed

Form CMS-1771 - go to https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-List.html

History

(Rev. 4111, Issued: 08-10-18, Effective: 9-11-18, Implementation: 9-11-18)

Provenance

Source: cms.gov
Retrieved: 2026-08-25
Edition: iom-2026-08-25
Content hash: 89e6b7d381f99482a9f674a62ef90e8953b30d9e8dc12deb32d02dbc6fe3f66f

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