Face to Face Encounter

4/5/11 New CMS Home Health Care Requirement for Physicians:

Face to Face Encounter We are contacting you to inform you of a new requirement that will affect physicians that order, and the patients that they refer, for Medicare home health services. In accord with the Patient Protection Affordable Care Act, CMS issued a Final Regulation that goes into effect April 1, 2011 (first published January 1, 2011) whereby Medicare will pay for home health services only when a patient has had a face-to-face encounter with the physician that certifies the home health plan of care in the 90 days prior to, or 30 days of, the start of services. The primary reason for home health services must be addressed during this encounter.

Physicians that work in collaboration with a nurse practitioner or a clinical nurse specialist, or supervise a physician’s assistant, the face-to-face encounter may be carried out by that non-physician practitioner who must have documented their clinical findings and communicated those finding to you. However, only a physician may order home health services, certify that a face-to-face encounter occurred, and certify that other eligibility criteria are met (medical necessity and homebound status)