Mastectomy Facility Accreditation Guide

ABC offers different accreditation programs tailored to the type of patient care services provided at each of your patient care locations. This program is only for facilities who provide Mastectomy only services (post-mastectomy prostheses and accessories) and these services must be provided by a certified or licensed mastectomy fitter. This program does not include pneumatic compression devices (lymphedema pumps).

If your facility is providing services or items not included with the Mastectomy program, please review our ABC Facility Accreditation Patient Care Guide, which is available on our website.

Remember that you must apply for ABC Accreditation in all of the services provided regardless of whether you are billing CMS or another payer for those services.

Eligibility Criteria

The following criteria will help you determine if you are eligible for accreditation. While not a comprehensive list, it covers the basic requirements that you must have in order to be eligible to apply to ABC. The remaining eligibility requirements are identified throughout the Standards and are relevant to specific products and services your organization provides.

Your organization must be:

• Located within the United States, one of its territories or possessions or be a Department of Defense medical treatment facility or program.
• A formally organized and legally established business that is currently providing the Durable Medical Equipment, Prosthetics, Orthotic, and Supplies (DMEPOS) services for which you are applying.
• Licensed according to applicable state and federal laws and regulations and maintains all current legal authorizations to operate.
• Operational and have a minimum of 5* complete patient charts per patient care provider available at the time of the onsite survey.
• Applying for ABC Accreditation for all of the services provided, regardless of whether Medicare or another payer is billed for these services. This requirement extends only to those services for which ABC offers accreditation.
• Applying for ABC Accreditation for all patient care locations. Each location must be in an appropriate clinical setting. The decision of what is an appropriate clinical setting is solely within ABC’s discretion.
• Compliant with state licensure requirements.
• Compliant by ensuring each patient care location is assigned a separate and unique NPI and PTAN.

In addition, you must:

• Clearly define the items and services you provide to patients, insurance companies, referral sources and regulatory bodies, including Medicare.
• Comply with the ABC Code of Professional Responsibility.
• Agree to the Terms of Agreement in the application and policies listed in this Guide.
• Not falsify or misrepresent your accreditation status.
• Apply for ABC Accreditation of any new facility that you have opened or acquired.

*If the facility is newly established and has a limited patient care history, ABC may determine that a minimum of five complete patient charts per patient care provider is acceptable.