The Affordable Care Act (ACA) established a face-to-face encounter requirement for certification of eligibility for Medicare home health services, by requiring the certifying physician to document that he or she, or a non-physician practitioner working with the physician, has seen the patient. The encounter must occur within the 90 days prior to the start of care, or within the 30 days after the start of care.
What is a face-to-face encounter for Medicare home health services?
The Affordable Care Act (ACA) established a face-to-face encounter requirement for certification of eligibility for Medicare home health services, by requiring the certifying physician to document that he or she, or a non-physician practitioner working with the physician, has seen the patient.
What are the requirements for face-to-face meeting with a physician?
The Affordable Care Act (ACA) added a requirement that prior to such certification the physician must document that the patient had a face-to-face encounter with an allowed physician or non-physician practitioner (NPP) within a reasonable timeframe as established by the Secretary of the U.S. Department of Health and Human Services. [2]
How do you record a face-to-face meeting with a doctor?
The face-to-face encounter must be documented in the pertinent portion of the medical record (for example, history, physical examination, diagnostic tests, summary of findings, progress notes, treatment plans or other sources of information that may be appropriate).
What is face to face encounter under the Affordable Care Act?
[2] Affordable Care Act (ACA) § 6407, Pub. Law No. 111-148 (March 23, 2010). The intent of the Face to Face Encounter provision was to reduce fraud, waste, and abuse by assuring that physicians or other healthcare providers actually meet with potential home health patients to ascertain their specific care needs.
What is Medicare face to face?
In addition to allowing NPPs to conduct the face-to-face encounter, Medicare allows a physician who attended to the patient in an acute or post-acute setting, but does not follow patient in the community (such as a hospitalist) to certify the need for home health care based on their contact with the patient, and ...
What is required for a face to face?
The initial (Start of Care) certification must include documentation that an allowed physician or non-physician practitioner (NPP) had a face-to-face (FTF) encounter with the patient. The FTF encounter must be related to the primary reason for the home care admission. This requirement is a condition of payment.
Can a nurse practitioner do a face to face encounter?
Q: Who qualifies as a non-physician practitioner (NPP)? A NPP may perform qualifying face to face encounter, must document and communicate findings from their counter to the qualified certifying physician.
How long is a F2F good for?
After an initial home health episode, recertification of the need for continued home care must be provided at least every 60 days, and must be signed and dated by the physician who reviews the plan of care.
Does Medicare require face to face?
The Affordable Care Act (ACA) established a face-to-face encounter requirement for certification of eligibility for Medicare home health services, by requiring the certifying physician to document that he or she, or a non-physician practitioner working with the physician, has seen the patient.
What is a face to face sheet?
Free Face Sheet Template for Communicating With Doctors. By Gilbert Guide. A face sheet is a document that gives a patient's information at a quick glance. Face sheets can include contact details, a brief medical history and the patient's level of functioning, along with patient preferences and wishes.
What should CMS do to ensure that all patients that need a face to face encounter receive one?
We recommend that CMS (1) consider requiring a standardized form to ensure that physicians include all elements required for the face-to-face documentation, (2) develop a specific strategy to communicate directly with physicians about the face-to- face requirement, and (3) develop other oversight mechanisms for the ...
Which of the following situations would require an oasis assessment?
Currently, OASIS requirements apply to all patients receiving skilled care reimbursed by Medicare, Medicaid, and Medicare or Medicaid managed care patients with the following exceptions: patients under the age of 18, patients receiving maternity services, patients receiving only chore or housekeeping services, and ...
Can nurse practitioners order home health in Florida?
Section 3708 of the CARES Act permanently authorizes nurse practitioners (NPs) to certify for Medicare and Medicaid home health care services in accordance with state law.
What is a face to face visit in hospice?
The recertification associated with a hospice patient's third benefit period, and every subsequent recertification, must include documentation that a hospice physician or a hospice nurse practitioner had a face-to-face (FTF) encounter with the patient.
What does CTI mean in hospice?
certification of terminal illnessCMS reminded hospices recently about the need to comply with Medicare hospice election statements and certification of terminal illness (CTI) requirements.
Can a PA do a hospice face to face?
NPs, while not permitted to recertify terminal illness, are permitted to conduct the face-to-face encounter to determine continued eligibility. PAs are not given the ability to conduct this face-to-face encounter.
What happens if a home health patient dies before the face-to-face encounter occurs?
If a home health patient dies shortly after admission before the face-to-face encounter occurs, if the contractor determines a good faith effort existed on the part of the HHA to facilitate/coordinate the encounter and if all other certification requirements are met, the certification is deemed to be complete.
What documentation must include the date when the physician or allowed NPP saw the patient?
The documentation must include the date when the physician or allowed NPP saw the patient, and a brief narrative composed by the certifying physician who describes how the patient’s clinical condition as seen during that encounter supports the patient’s homebound status and need for skilled services .
What is Medicare Fee for Service Compliance?
Medicare Fee-for-Service Compliance Programs: Medical Review and Education, Face-to-Face Encounter Requirement for Certain Durable Medical Equipment
Who maintains the written order/prescription and the supporting documentation provided by the treating practitioner?
A supplier must maintain the written order/prescription and the supporting documentation provided by the treating practitioner and make them available to CMS and its agents upon request.
Does Medicare use DMEPOS?
Any Medicare provider or supplier that writes DMEPOS orders or prescriptions will now use a standard set of elements that will be applicable to all DMEPOS items.
Can CMS suspend a face to face meeting?
CMS may suspend the face-to-face encounter and written order prior to delivery requirements generally, or for a particular item or items, at any time and without creating a new rule, except for those items included on the Master List due to statutory mandate.
Do you need a face to face encounter for DMEPOS?
A new rule streamlines and simplifies (PDF) the order requirements for DMEPOS items, and outlines items that need a face-to-face encounter, written order prior to delivery, and/or prior authorization. (Note that due to the COVID-19 pandemic, we are not requiring face-to-face encounters unless statutorily imposed. For this reason, the Required Face-to-Face Encounter and Written Order Prior to Delivery List is not available. We will post this list on this page when the requirement is in effect again.)
How many licensed counselors are there in Medicare?
By passing the Mental Health Access Improvement Act, and allowing the well over 100,000 licensed counselors and marriage and family therapists to render services to Medicare beneficiaries, legislators have an opportunity to create significant gains in access to mental health care for millions of Americans.
Who is addressed as the honorable?
Be sure you use the correct address and salutation. All Presidential appointees and Federal- and State-elected officials are addressed as The Honorable. (b) All Mayors are addressed as The Honorable. However, as a general rule, county and city officials are not addressed as The Honorable.
How to find out who you can vote for?
You will find them by searching the Internet by your state or territory of official residence, followed by “.gov” such as California representatives.gov. Alternatively, you can search for Representatives or Senators HERE.
Can you see a new patient via telehealth?
While requiring in-person visits to establish the doctor-patient relationship was a part of many states’ telehealth medicare laws in years past, the trend has been moving towards allowing providers to see new clients via telehealth for the first visit. Enter COVID-19 and the emergency measures put in place to allow for greater coverage and access to healthcare. Many mental health providers closed their brick-and-mortar offices and have guided their new and existing clients to telehealth use to reduce the spread of the virus. (See Virtual Waiting Room.)
Can a counselor be billed by Medicare?
Under the current Medicare law, counselors continue to be excluded from being reimbursed by Medicare for providing counseling services. Only psychiatrists, psychologists, clinical social workers, and psychiatric nurses are allowed to bill Medicare for counseling services provided to Medicare beneficiaries. Although many attempts to pass Medicare laws to include counselors as Medicare providers have been attempted over the years, none has been successful. On January 21, 2021, however, Rep. Mike Thompson (CA- 05) and Rep. John Kato (NY-24) reintroduced the Mental Health Access Improvement Act, a bipartisan bill that would allow counselors and marriage and family therapists to become Medicare providers. See
Does Medicare require telehealth visits?
New Medicare Law Requires In-Person Visit for Telehealth Coverage. In December 2020, the Consolidated Appropriations Act of 2020 , section 123 includes language that requires behavioral health providers to have seen their client in person during the prior six months before a telehealth visit will be covered by Medicare.
Do you have to meet with Medicare patients every 6 months?
Yes, you are right. As the law reads now, to continue being reimbursed, you must meet face to face every 6 months with all your Medicare patients. The absurdity of this law needs to be addressed by our community ASAP, which the reality is sinking in and legislators are focused on advancing telehealth.
Standardized DMEPOS Written Order/Prescription
Consolidated DMEPOS Lists
Required Face-To-Face Encounter and Written Order Prior to Delivery List
Written Order Prior to Delivery (WOPD) Requirements
Face-To-Face Encounter Requirements Applicable to Certain DMEPOS Items
- For all items requiring a face-to-face encounter, a practitioner visit is required within six months preceding the order. Note: face-to-face encounters for PMDs were previously required within 45 d...
- The encounter must be used to gather subjective and objective information associated with diagnosing, treating, or managing a clinical condition for which the DMEPOS is ordered.
- For all items requiring a face-to-face encounter, a practitioner visit is required within six months preceding the order. Note: face-to-face encounters for PMDs were previously required within 45 d...
- The encounter must be used to gather subjective and objective information associated with diagnosing, treating, or managing a clinical condition for which the DMEPOS is ordered.
- The face-to-face encounter must be documented in the pertinent portion of the medical record (for example, history, physical examination, diagnostic tests, summary of findings, progress notes, trea...
- If the encounter is performed via telehealth, the requirements for telehealth services and payment for telehealth servicesmust be met.
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