Physician/Client Face-to-Face Encounter Requirements for Home Health Services Clarified


CMS has issued Transmittal 139 to the Medicare Benefit Policy Manual dated February 16, 2011, clarifying the provisions requiring face-to-face encounters between the certifying physician and the home health patient. The new requirements in Transmittal 139 will be implemented March 10, 2011. In order for a patient to be certified to receive home health services, a physician must certify that the home health services are needed because the patient is confined to the home. For home health care services starting after January 1, 2011, the physician must document that he or an allowed non-physician practitioner (“NPP”) has had a face-to-face encounter with the patient. The face-to-face encounter must occur no more than 90 days prior to the home health start of care date or within 30 days after the start of care.

Although certain NPPs may perform the face-to-face encounter and inform the certifying physician regarding the clinical findings exhibited by the patient during the encounter, the certifying physician must document the encounter and sign the certification. The NPPs who are allowed to perform the face-to-face encounter are...

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