OPT Medicare Certification Resources and Forms

This will provide you with the requirements and necessary paperwork required by 42 CFR 485.703-485.729 to complete the Medicare Certification process.

• How to Apply
• Interpretive Guidelines - OPT/SP (Appendix E)
• Health Insurance Benefit Agreement
• Request for Certification in the Medicare/Medicaid Program to Provide OPT/SP Services
• Office of Civil Rights Information
• State Disclosure of Ownership and Control Interest Statement