Face-to-Face Encounter Requirement
The Centers for Medicare and Medicaid Services (CMS) now require a face-to-face physician encounter to certify patients for homecare. Effective April 1, 2011, all Medicare patients receiving homecare services must be seen by a physician 90 days prior to or 30 days after their admission to home healthcare services. Physicians must now document face-to-face encounters with patients and certify that the patient has a defined need for homecare services.
A Face-to-Face Encounter and HomeCare Certification Form must be provided to the homecare agency prior to admission. In some cases, the homecare agency may refuse to accept patient referrals without receiving the documentation in advance. If documentation is not received within 30 days of the start of care, the homecare agency will be forced to discharge the patient.
- The Face-to-Face Encounter and Home Care Certification Form does not replace the Homecare Orders Form (485) that is sent to you certifying the patient's plan-of-care.
- CMS requires free text answers to the questions.
- The form must be completed and signed by a physician.
Click this link to print or download MedStar VNA's form:
Face-to-Face Encounter and Homecare Certification Form
To review a presentation that offers more detail and instructions for meeting this regulatory requirement, review the Guide to Home Health Certification. For more information about the face-to-face encounter requirement and answers to frequently asked questions, visit the CMS website: http://questions.cms.hhs.gov
Helpful tips for completing the form
Remember to document the date you had the face-to-face encounter with the patient and check one of the qualifying services where indicated.
Examples of how to document clinical findings that support the need for homecare services being ordered:
- "Patient needs monitoring, education and treatment for newly diagnosed heart failure disease."
- "Patient needs monitoring and treatment for recovery from joint replacement surgery."
Examples of how to document and certify homebound status:
- "Patient experiences considerable and taxing effort when leaving the home."
- "Patient requires assistance from other person(s) and/or devises to leave the home."
For more information or to refer a patient to MedStar VNA, call 800-862-2166. Press 1 to speak with someone from our Referral Center