Updates: Medicare requirements for home health services

Posted on: January 19th, 2011 by sdavis

As a partner in care with your home health agency, we want to serve as a resource for changes to the home care industry. You’ve probably read that Medicare home health patients will require a face-to-face physician encounter for episodes of care beginning April 1, 2011. We’ve researched the rules of this new requirement and have compiled a summary to help educate you and your staff.

To encourage greater involvement of the physician in a patient’s home health care services, patients are now required to be seen face-to-face by the physician, or certain non-physician practitioners working with the physician, before home health services start or soon after the start of care.

The key element of this new law to remember is that the patient must have the face-to-face visit within 90 days of the start of home care or within 30 days of the start of care. In addition, the visit must be with the physician who is or will be caring for the patient during the home health care. Finally, the encounter must be for medical service related to the reason why home health services are needed.

If the patient is being cared for by a nurse practitioner, physician’s assistant, clinical nurse specialist, or certified nurse midwife, visits with these professionals may meet the requirement too.

Be sure to read and review the checklist of new requirements for Medicare coverage of home care services.

It's important for patients and healthcare providers to familiarize themselves with the new requirements for face-to-face encounters before the start of home health services.

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