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

January 24, 2014
Rick Gawenda

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

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