Part B Insider (Multispecialty) Coding Alert

Published on Fri May 24, 2013 PDF

If your physicians have been visiting home care patients more often due to 2013’s face-to-face visit requirement, know that this rule does not mean that you have to see the patient every time his or her condition changes.

“The face-to-face encounter is only required for the initial episode of home health services,” HHH Medicare Administrative Contractor National Government Services reminds providers. Medicare doesn’t require F2F for subsequent episodes. “An additional face-to-face document would not be required unless the patient was discharged from home health and then readmitted with 60 days or more between episodes,” NGS explains.

That includes when the patient’s diagnosis changed for a recert or resumption of care, NGS says in a question-and-answer document from its April 24 webinar on “Understanding the Medicare Home Health Coverage Guidelines.”

“It would not be necessary to get another face-to-face encounter,” NGS clarifies. “It is only required for the initial episode of care.”