MD Orders for Care

The Physician Orders Care

* All care provided by home health professionals MUST be ordered by the physician. The physician must SIGN a plan of treatment (485) and any additional or subsequent supplementary orders.

* The physician MUST be apprised immediately of any change in condition, whether that be an improvement in status, or a decline.

* If the patient is on Medicare, the physician can bill for the time spent on care plan oversight. See CMS sight for details.

* Orders MUST be signed by an MD, DO, or Podiatrist. They may NOT be signed by an RN, PA, APRN or NPHopefully this will change in the near future. Please contact your Senators and Representative today! There has been legislation in both the House and Senate THAT MUST BE RE-INTRODUCED AND PASSED!

Until then the rule stands...

Per CGS Intermediary as of 4/20/17

All services provided under the Medicare home health benefit must be ordered by a physician. Three basic requirements for ordering services are:

  • The physician must be enrolled in Medicare;
  • The ordering National Provider Identifier (NPI) must be for an individual physician (not an organizational NPI); and
  • The physician must be of a specialty type that is eligible to order and refer.

FACE to FACE Requirements:

For initial home health certifications, the certifying physician must document that the physician himself or herself, an allowed NP, 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. 

This statement is found in a pdf document available online from the CMS SITE


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