Documentation Requirements for Home Health Prospective Payment System Face-to-Face Encounter

The Centers for Medicare and Medicaid Services has released an article intended for physicians who refer patients to home health, order home health services, and/or certify patients’ eligibility for the Medicare home health benefit, home health agencies, and non-physician practitioners (NPPs). Effective January 1, 2011, the Affordable Care Act mandates that prior to certifying a beneficiary’s eligibility for the HH benefit, the certifying physician must document that he or she or an allowed non-physician practitioner (NPP) had a face-to-face encounter with the beneficiary. This article provides the narrative requirements of what a physician or NPP must document in the medical record during that face-to-face encounter to support the need for home health services. The article also provides incorrect and correct examples of proper physician/NPP documentation to support the need for home health services. To view the article, Click