Certify Providers of Outpatient Physical Therapy, Speech Pathology Services or Occupational Therapy

Purpose: This procedure briefly describes the steps necessary to certify providers of outpatient physical therapy, speech pathology services, or occupational therapy. The federal requirements can be found in the Code of Federal Regulations (CFR) at 42 CFR 485.703-485.729

Contacts: For questions regarding any part of this process, please contact the appropriate section of the N.C. Division of Health Service Regulation:

Acute and Home Care Licensure and Certification Section 919-855-4620


  1. Contact the Acute and Home Care Licensure and Certification Section
    1. The applicant contacts the Acute and Home Care Licensure and Certification Section three months prior to operation for an application packet.
    2. The applicant completes the information and returns it to the section.
    3. As soon as the applicant is ready for operation, they contact the section to request an on-site survey.
    4. The Medicare application (CMS Form 855) is forwarded by the provider to the fiscal intermediary for approval. An initial survey will be scheduled with approval of the application by the fiscal intermediary.
    5. If the applicant has deficiencies during the initial survey, then the effective date for Medicare/Medicaid participation is the date the section receives an acceptable plan of correction signed by the applicant.
    6. The section assigns the Center for Medicare & Medicaid Services Certification Number (CCN) and notifies the fiscal intermediary.