Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104)

What this rule requires your agency to do

• 1For long-term home health continuation, the face-to-face annual encounter must occur on a rolling 12-month basis, within 90 days prior or 30 days after the previous year's face-to-face date.(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 2A new face-to-face encounter is required after an interruption in home health services of 60 days or more from the end of the last authorization period.(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 3The total medical plan of care must be reviewed by the ordering practitioner and home health agency personnel at least once every 60 days per 42 CFR 484.60(c)(1).(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 4Members must be involved in, aware of, and acknowledge the plan of care and be given a copy, per 42 CFR 484.60(e).(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 5A face-to-face must be documented within the past 12 months and valid at the time of the PA request by January 1, 2026.(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 6The home health agency is responsible for submitting the face-to-face documentation to the payer's PA contractor; the practitioner may not verbally relay the encounter for the agency to document.(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 7The comprehensive assessment must be submitted with the plan of care along with the Home Health CMS 485 form.(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))
• 8A qualified treating practitioner must document the face-to-face encounter including the date the patient was seen, detailed clinical findings, the connection between findings and home health needs, and practitioner signatures and dates on all required documents.(Face-to-face encounter and documentation requirements clarified for home health PA requests (BT2025104))