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Outpatient Physical Therapy (OPT)/Speech Pathology Providers
This page is designed to assist providers through the federal certification process, as well as provide additional resources to maintain compliance.
State licensing is not required for OPT/speech pathology CMS certified providers. Individual health professionals should check on licensure requirements with the Bureau of Professional Licensing.
Federal Certification Process
OPT/speech pathology providers may apply for certification to participate in the Medicare/Medicaid programs. The Centers for Medicare and Medicaid Services (CMS) contracts with LARA to evaluate compliance with the federal regulations by conducting certification surveys and complaint investigations.
FEDERAL CERTIFICATION PROCESS
For initial certification or change of ownership:
- Complete Provider Enrollment Application (CMS-855A) and submit to Medicare Administrative Contractor (MAC)/Federal Fiscal Intermediary (FI).
- Complete and submit to BCHS:
- An e-mail confirming a successful electronic submission of your Civil Rights Clearance for Medicare Provider Certification from the Office for Civil Rights (OCR)
- Two (2) signed originals Health Insurance Benefit Agreement (CMS-1561)
- One (1) signed original Request for Certification in the Medicare and/or Medicaid Program to Provide Outpatient Physical Therapy and/or Speech Pathology Services (CMS-1856)
Contact Accrediting Organization (AO) to schedule survey (for initial certification only)
For address changes:
- Notify the Regional Office of CMS in writing of its intention to move 90 days prior to relocation
- Complete Provider Enrollment Application (CMS-855A) and submit to MAC/FI
* Note-a survey must be completed for all primary site address change
For extension site application (one application packet per site):
- Complete Provider Enrollment Application (CMS-855A) and submit to MAC/FI.
- Complete Extension Site Application (BCHS-SHCS-805) and submit to BCHS.
For a change in administrator, please email LARA-BSCSupport@michigan.gov the following:
- Facility name, address, and provider #
- New administrator full name
- Effective start date of administrator
Federal Reciprocal Agreements - For a federally certified provider in Michigan to provide services in another state, the provider must be federally certified in the other state or the provider must be recognized under a CMS-approved Reciprocal Agreement between the State of Michigan and the other applicable state. Michigan has no reciprocal agreement with Indiana, Ohio or Wisconsin for Outpatient Physical Therapy (OPT)/Speech Pathology services. In short, federally certified OPT/Speech Pathology providers in Michigan cannot offer services within a neighboring state unless certified as a provider within that state.
Michigan Department of Licensing and Regulatory Affairs
Bureau of Community & Health Systems - Federal Certification
611 W. Ottawa Street
PO Box 30664
Lansing, MI 48909
FAX: (517) 763-0214
- CMS Conditions of Participation/for Coverage – Federal
- CMS Forms – Federal
- HHS Forms (Civil Rights) – Federal
- State Operations Manual – Federal
- Wisconsin Physician Services (WPS) – MAC/FI
- American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) – AO