Medicare certification means a facility has met the federal Conditions of Participation on survey and is approved to bill Medicare. It is a federal status, not a marketing label. CMS records 26,250 active certified facilities in its public Provider of Services file, from home health agencies to dialysis centers.
What certification means
The Conditions of Participation are the federal health-and-safety standards an institutional provider must meet to take part in Medicare and Medicaid. Certification is the determination — made after a survey — that a facility meets them. Without it, a home health agency, hospice, nursing home, dialysis center, or surgical center cannot be paid by Medicare for covered care. The status is recorded in CMS systems, so it can be confirmed against a primary source rather than taken on a provider’s word.
How a provider gets certified
- Enroll in Medicare through the PECOS system to establish the provider record.
- Request certificationfor the relevant setting and prepare for survey against that setting’s Conditions of Participation.
- Pass the survey — by a state survey agency or, where allowed, a CMS-approved accrediting body under deemed status.
- Receive a CCN — the CMS Certification Number that identifies the certified facility in every federal file.
Certification is ongoing, not one-time: facilities are re-surveyed, and serious uncorrected deficiencies can lead to enforcement up to termination.
Certification and the CCN
When a facility is certified, CMS assigns it a CMS Certification Number — formerly the OSCAR or Medicare Provider Number. The CCN is the federal join key: it ties a facility’s certification record in the Provider of Services file to its quality data on Care Compare and its enforcement history. If you know a facility’s CCN, you can trace its certification, setting, and inspection record across every CMS file.
Certification by setting
Each setting has its own Conditions of Participation and its own survey. The certified populations CMS publishes today:
How to confirm a facility is certified
Because certification is a federal record, you do not have to rely on a brochure. Look the facility up by its CCN or name in the Provider of Services file and on Care Compare. Each record shows the setting, the certification status, and — where applicable — the quality rating and inspection history, with the source and snapshot date attached.
Medicare certification, by the numbers
Confirm a certification
Look up any Medicare-certified facility by setting and state — each record traced to its CMS source and snapshot date.
Browse certified facilities →Frequently asked questions
- What does Medicare-certified mean?
- A Medicare-certified provider has been surveyed against the federal Conditions of Participation and approved to bill Medicare for covered services. Certification is a federal status recorded in CMS systems — it is not a marketing claim. CMS lists 26,250 active certified facilities in its public Provider of Services file.
- How does a home health agency become Medicare-certified?
- A home health agency enrolls in Medicare, then is surveyed against the home health Conditions of Participation by a state agency or a CMS-approved accrediting body. Once it passes and is assigned a CMS Certification Number, it can bill Medicare. CMS publishes 12,392 certified home health agencies on Care Compare.
- Is Medicare certification the same as accreditation?
- No, though they are linked. Certification is the federal eligibility status to bill Medicare. Accreditation is approval by a CMS-recognized private body — such as a hospital accreditor — that CMS may accept in place of a state survey (called deemed status). A facility can be certified through a state survey without separate private accreditation.
- How is certification different from enrollment in PECOS?
- Enrollment registers a provider in Medicare through the PECOS system so it can submit claims. Certification is the survey step that confirms an institutional provider meets the Conditions of Participation. Individual clinicians enroll but are not certified; institutional providers like agencies and facilities must do both.
- Can a facility lose Medicare certification?
- Yes. CMS can terminate certification when a provider fails to correct serious deficiencies found on survey, and it can impose intermediate enforcement such as denial of payment for new admissions before termination. A terminated facility can no longer bill Medicare; the Provider of Services file records both active and terminated facilities.
- How do I confirm a facility is Medicare-certified?
- CMS publishes certified-facility records in the Provider of Services file and Care Compare under a CMS Certification Number. Fonteum mirrors loaded federal records and displays available source and snapshot metadata on supported fields, so you can confirm a facility's certification status, setting, and CCN against the primary source.
Related
- What is a CCN (CMS Certification Number)? — the federal join key a facility receives when it is certified.
- What is PECOS? Medicare enrollment — the enrollment step that comes before certification.
- Medicare home health care: what’s covered — what a certified home health agency can bill Medicare for.
- The CMS Five-Star Quality Rating — how certified facilities are then scored on quality.
- Medicare enrollment data (PECOS) — the enrollment file behind every certified provider.
- Care Compare facility data — loaded certified-facility records by setting, with available provenance metadata on supported fields.