THE HOME HEALTH BENEFIT DEFINED

The Centers for Medicare and Medicaid Services requires the following criteria be met before a beneficiary may qualify for the Home Health benefit. Those criteria are the following:

  • The patient must have had a face-to-face encounter with a physician or an allowed non-physician practitioner within 90 days prior to or 30 days after the date of home health admission. (Nurse practitioner, Physicians’ Assistant)

  • The patient must be confined to the home and meet homebound criteria

  • The services ordered must be medically necessary

  • Receive services under an established or signed plan of care reviewed by a physician

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The Face To Face Encounter