The brief required narrative that must be included in the face-to-face encounter form that physicians sign must adhere to two new sets of criteria CMS introduced last November to justify homebound status. CMS listed the new criteria in a Nov. 14 MLN Matters article.
The new criteria requires an indication that patients must either need to use supportive devices, such as crutches, canes or wheelchairs to leave home or that they have a condition that would cause leaving the home to be medically contraindicated. In addition, patients must also normally be unable to leave home and doing so must require from them a “considerable and taxing effort.”
The article also repeats CMS’ guidance that diagnoses alone do not support the need for skilled services and that standard language such as “taxing effort” is not acceptable to support that the patient is homebound; more specific information about conditions that warrant home care is required. The MLN Matters article is at
http://go.cms.gov/1aBU9HF.