The Centers for Medicare and Medicaid Services (CMS) recently issued a special edition of their MLN Matters newsletter in an effort to clarify the new documentation requirements for the face-to-face (F2F) encounter requirement. The article reiterates that the encounter document must include an explanation of why the clinical findings support that the patient is homebound and in need of either intermittent skilled nursing services or therapy services. Diagnoses alone do not support the need for skilled service and standard language such as “taxing effort” or a notation such as “gait abnormality” alone do not support homebound status.
CMS reviews the coverage criteria for skilled nursing and therapy home health services and describes the two criteria required for a beneficiary to be homebound. Examples of appropriate documentation are provided relative to the coverage criteria.