CMS Revises Home Visit Documentation Requirements

CMS Revises Home Visit Documentation Requirements

The Centers for Medicare & Medicaid Services (CMS) announced in the 2019 Physician Fee Schedule Final Rule that it will eliminate some home visit documentation requirements.

Payment rates for E/M visits in the patient’s private residence (99341-99350) are marginally higher than those for the equivalent office-based visits. In previous years, home visit documentation had to justify the medical necessity of a home visit made in lieu of a (less expensive) office or outpatient visit. As part of an ongoing effort to lessen providers’ administrative burden when documenting E/M services, CMS proposed earlier this year to scrap this requirement.

Evaluation and Management – CEMC

Commenters supported the move, suggesting “that whether a visit occurs in the home or the office is best determined by the practitioner and the patient without applying additional rules.” CMS agreed, and per the Final Rule has finalizing a policy change to remove the requirement that the medical record must document the medical necessity of furnishing the visit in the home rather than in the office, as proposed, effective January 1, 2019.

John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

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About Has 590 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

3 Responses to “CMS Revises Home Visit Documentation Requirements”

  1. Lisa Merkow says:

    We always have follow up documents – lisamerkow.com

  2. Jeff says:

    It is unclear from this posting if a home visit can be made on a patient who can be seen in the office.
    All it states is that you don’t have to document what the reason is for justifying the home visit.
    It makes it confusing.

  3. Carolyn says:

    I am also wondering if a patient that can be seen in the office can now be seen in the home for say convenience factors since you no longer have to prove home bound status. Any information is appreciated. Thank you.

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