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 a PA or NP. 

Hopefully this will change in 2015. Please contact your Senators and Representative today! There is legislation in both the House and Senate today to change this. 

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

Face to Face Requirements are changing. Stay tuned to CMS for news on the new rules.

Back to The Basics


© 2009-present by Kathy Quan RN BSN -- ALL RIGHTS RESERVED 
No portion of this documentation can be used without written permission. EMAIL me for permission to use. 

  © 2005-Present -- ALL RIGHTS RESERVED.  This information may not  be used without written permission:  contact us