CMS Proposes Streamlined Medicare Certification for Outpatient Therapy Providers Through New Attestation Process
The Centers for Medicare & Medicaid Services (CMS) has opened a crucial public comment period regarding a proposed revision to its information collection process for certain Medicare providers, signaling a shift toward potentially less burdensome administrative procedures. Published in the Federal Register on May 18, 2026, this notice invites stakeholders to provide feedback on changes to Form CMS-381, which governs the certification requirements for Medicare Outpatient Physical Therapy (OPT) and Outpatient Speech Pathology (OSP) providers.
Understanding the Regulatory Framework
This action by CMS falls under the purview of the Paperwork Reduction Act of 1995 (PRA). The PRA mandates that federal agencies like CMS publish notices in the Federal Register when proposing new or revising existing collections of information from the public. The primary goal is to ensure that federal information collections are necessary, minimize burden on the public, and enhance the quality and utility of the collected data. This 60-day comment period, ending July 17, 2026, is a standard and vital step in that process, allowing affected parties to voice concerns or offer improvements regarding CMS's burden estimates and the practical implications of the proposed changes.
The Evolving Certification Process for Therapy Providers
The core of the CMS announcement centers on a revision to Form CMS-381, titled "Medicare Outpatient Physical Therapy/Outpatient Speech Pathology (OPT/OSP) Providers Certification Requirements." Historically, this form has been essential for initial certification, during recertification surveys, and when providers request changes to their locations. The current revision introduces a substantial procedural change: a new program that permits certain providers to recertify every six years through self-attestation, rather than undergoing traditional recertification surveys conducted by State Survey Agencies (SAs).
Specifically, the instructions for Form CMS-381 are being modified. A reference to recertification surveys will be deleted and replaced with a clear reference to this "recertification attestation process." This program extends to not only OPT/SLP providers but also Comprehensive Outpatient Rehabilitation Facilities (CORFs), Rural Health Clinics (RHCs), and Portable X-Ray (PXR) suppliers. Under this new model, Form CMS-381 will still be required for new OPT/SLP providers seeking initial certification and for existing providers making significant operational changes, such as adding or deleting services, or closing or adding extension locations. It will also be used when existing OPT/SLP providers are recertified by an SA through either a survey or the new attestation method every six years.
For OPT/SLP providers that are deemed by a CMS-approved Accrediting Organization (AO), the CMS-381 will continue to be part of their reaccreditation surveys, which typically occur at least every 36 months.
Operational Impact and Oversight
The proposed changes carry significant operational implications for both providers and regulatory bodies. The move to a self-attestation model for some recertifications could potentially reduce the administrative and logistical burden on providers, allowing them to allocate more resources to patient care rather than preparing for frequent on-site surveys. Similarly, State Survey Agencies may see a shift in their workload, allowing them to focus resources on initial certifications or providers that do not qualify for the attestation program.
Importantly, CMS emphasizes continued oversight, particularly concerning extension locations. OPT/SLP providers often render services not only on their primary premises but also at other institutions, such as skilled nursing facilities, or other owned, leased, or rented sites. These are considered extension locations if services are billed to Medicare and rendered in a designated area for rehabilitation care. A patient's home, however, is explicitly not considered an extension location. These extension locations are considered part of the primary provider's site and are subject to the same approval policies and federal requirements, falling under the OPT/SLP provider agreement and identified by the same provider number. Form CMS-381 remains crucial for SAs, AOs, and the CMS Survey Operations Group to identify and monitor these locations, ensuring compliance with federal requirements.
Call for Stakeholder Input
CMS is actively soliciting public comments on several key aspects of this information collection. Interested parties are encouraged to provide feedback on the necessity and utility of the proposed collection, the accuracy of CMS's estimated burden on respondents, ways to enhance the quality, utility, and clarity of the information to be collected, and the potential use of automated collection techniques or other forms of information technology to minimize burden. This comment period represents a critical juncture for providers and other stakeholders to shape the final implementation of this revised certification process, ensuring that the new framework effectively balances administrative efficiency with robust patient safety and program integrity.
