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The following text is the complete Chapter 7, Home Health Services, of the Medicare Benefit Policy Manual. This version was retrieved on 31 May 2016. Always verify you have the most recent information from https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf.

Medicare Benefit Policy Manual: Chapter 7 - Home Health Services

Table of Contents

(Rev. 208, 05-11-15)

Transmittals for Chapter 7

  • 10 - Home Health Prospective Payment System (HH PPS)

    • 10.1 - National 60-Day Episode Rate

    • 10.2 - Adjustments to the 60-Day Episode Rates

    • 10.3 - Continuous 60-Day Episode Recertification

    • 10.4 - Counting 60-Day Episodes

    • 10.5 - Split Percentage Payment Approach to the 60-Day Episode

    • 10.6 - Physician Signature Requirements for the Split Percentage Payments

    • 10.7 - Low Utilization Payment Adjustment (LUPA)

    • 10.8 - Partial Episode Payment (PEP) Adjustment

    • 10.9 - Outlier Payments

    • 10.10 - Discharge Issues

    • 10.11 - Consolidated Billing

    • 10.12 - Change of Ownership Relationship to Episodes Under PPS

  • 20 - Conditions To Be Met for Coverage of Home Health Services

    • 20.1 - Reasonable and Necessary Services

      • 20.1.1 - Background

      • 20.1.2 - Determination of Coverage

    • 20.2 - Impact of Other Available Caregivers and Other Available Coverage on Medicare Coverage of Home Health Services

    • 20.3 - Use of Utilization Screens and “Rules of Thumb”

  • 30 - Conditions Patient Must Meet to Qualify for Coverage of Home Health Services

    • 30.1 - Confined to the Home

      • 30.1.1 - Patient Confined to the Home

      • 30.1.2 - Patient’s Place of Residence

    • 30.2 - Services Are Provided Under a Plan of Care Established and Approved by a Physician

      • 30.2.1 - Content of the Plan of Care

      • 30.2.2 - Specificity of Orders

      • 30.2.3 - Who Signs the Plan of Care

      • 30.2.4 - Timeliness of Signature

      • 30.2.5 - Use of Oral (Verbal) Orders

      • 30.2.6 - Frequency of Review of the Plan of Care

      • 30.2.7 - Facsimile Signatures

      • 30.2.8 - Alternative Signatures

      • 30.2.9 - Termination of the Plan of Care - Qualifying Services

      • 30.2.10 - Sequence of Qualifying Services and Other Medicare Covered Home Health Services

  • 30.3 - Under the Care of a Physician

  • 30.4 - Needs Skilled Nursing Care on an Intermittent Basis (Other than Solely Venipuncture for the Purposes of Obtaining a Blood Sample), Physical Therapy, Speech-Language Pathology Services, or Has Continued Need for Occupational Therapy

  • 30.5 - Physician Certification and Recertification of Patient Eligibility for Medicare Home Health Services

    • 30.5.1 - Physician Certification

      • 30.5.1.1 - Face-to-Face Encounter

      • 30.5.1.2 - Supporting Documentation Requirements

    • 30.5.2 - Physician Recertification

    • 30.5.3 - Who May Sign the Certification or Recertification

    • 30.5.4 - Physician Billing for Certification and Recertification

  • 40 - Covered Services Under a Qualifying Home Health Plan of Care

    • 40.1 - Skilled Nursing Care

      • 40.1.1 - General Principles Governing Reasonable and Necessary Skilled Nursing Care

      • 40.1.2 - Application of the Principles to Skilled Nursing Services

        • 40.1.2.1 - Observation and Assessment of the Patient’s Condition When Only the Specialized Skills of a Medical Professional Can Determine Patient’s Status

        • 40.1.2.2 - Management and Evaluation ...

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