Face-to-Face Encounter
Home Health Care
As of April 1, 2011 the Centers for Medicare and Medicaid Services requires a patient/physician face-to-face encounter as a condition for reimbursement of home health care services.
*Face-to-face requirement for Medicare patients only if Medicare is primary or secondary.
Who qualifies to perform the face-to-face encounter?
- Primary physician
- Any hospitalist or community-based physician (any specialty)
- Physician representative to include a certified midwife, a nurse practitioner or a physician’s assistant
When does the face-to-face encounter need to take place?
- Only required for the initial home health certification period
- Up to 90 days prior to start of care or up to 30 days after the start of care, or
- If not within 90 days, not more than 30 days after the first home care visit
What should be included in the documentation of the face-to-face encounter?
- Date of visit
- Primary reason for receiving home health care
- Explanation of how clinical findings support the need for skilled services for home health care
- Explanation of how clinical findings support the patient’s homebound status
- Physician’s signature and date
- Physician may use supporting documents such as visit notes or discharge summary to supplement the addendum