Section 441.151 - General requirements(a) Inpatient psychiatric services for individuals under age 21 must be: (1) Provided under the direction of a physician;(2) Provided by- (i) A psychiatric hospital that undergoes a State survey to determine whether the hospital meets the requirements for participation in Medicare as a psychiatric hospital as specified in § 482.60 of this chapter, or is accredited by a national organization whose psychiatric hospital accrediting program has been approved by CMS; or a hospital with an inpatient psychiatric program that undergoes a State survey to determine whether the hospital meets the requirements for participation in Medicare as a hospital, as specified in part 482 of this chapter, or is accredited by a national accrediting organization whose hospital accrediting program has been approved by CMS.(ii) A psychiatric facility that is not a hospital and is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Commission on Accreditation of Rehabilitation Facilities, the Council on Accreditation of Services for Families and Children, or by any other accrediting organization with comparable standards that is recognized by the State.(3) Provided before the individual reaches age 21, or, if the individual was receiving the services immediately before he or she reached age 21, before the earlier of the following- (i) The date the individual no longer requires the services; or(ii) The date the individual reaches 22; and(4) Certified in writing to be necessary in the setting in which the services will be provided (or are being provided in emergency circumstances) in accordance with § 441.152 .(b) Inpatient psychiatric services furnished in a psychiatric residential treatment facility as defined in § 483.352 of this chapter, must satisfy all requirements in subpart G of part 483 of this chapter governing the use of restraint and seclusion. 66 FR 7160 , Jan. 22, 2001, as amended at 75 FR 50418 , Aug. 16, 2010; 86 FR 61617 , Nov. 5, 2021; 88 FR 36510 , June 5, 2023 86 FR 61617, 11/5/2021; 88 FR 36510, 8/4/2023