CMS Clarifies “Confined to the Home” Definition

The Centers for Medicare and Medicaid Services (CMS) has issued clarification on the definition of the patient as being “confined to the home” to more accurately reflect the definition as articulated at Section 1835(a) of the Social Security Act. In addition, vague terms, such as “generally speaking”, have been removed to ensure clear and specific requirements of the definition. These changes present the requirements first and more closely align the policy manual with the Act. This will prevent confusion, promote a clearer enforcement of the statute, and provide more definitive guidance to HHAs in order to foster compliance.

To access the CMS clarification of when a Medicare beneficiary shall be considered “confined to the home” (homebound), click