Medical Orders for Care

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* All care provided by home health professionals MUST be ordered by the patient's practitioner. (This now includes MD, DO, Podiatrist, NP and PA.) The practitioner must SIGN a plan of treatment (485) and any additional or subsequent supplementary orders.
* The practitioner 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 site for details.
* Orders MUST be signed by an MD, DO, or Podiatrist and under the CARES Act of 2020, an NP or PA may now order home health care and continue to make the Face to Face Visits.

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.
CMS Power Point (2022)
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