For episodes with starts of care beginning January 1, 2011 and later, prior to initially certifying the home health patient’s eligibility, the certifying physician must document that he or she, or an allowed non-physician practitioner (NPP) had a face-to-face encounter with the patient. The encounter and documentation are a condition of payment. The initial certification is incomplete without them.
For initial home health certifications, the certifying physician must document that the physician himself or herself, an allowed NPP, or a physician caring for the patient in an acute or post-acute facility who has privileges at the facility had a face-to-face encounter with the patient.
The face-to-face encounter must occur within 90 days prior to the home health start of care date or within 30 days after the start of care.
The face-to-face encounter can be performed via a telehealth service, in an approved originating site.
Prior to billing, the home health agency should ensure that all certifications are complete, including that the face-to-face documentation that has been clearly titled, dated, and signed by the certifying physician.