Home Health Face-to-Face Encounter Documentation

Documents the certifying physician or allowed practitioner face-to-face encounter supporting homebound status and skilled need for home health certification.

Encounter Timing and Patient Context

• Patient Identifier
  Use the internal medical record number or other organization-approved identifier. Do not enter SSN.
• Start of Care Date
  Date home health services started.
• Face-to-Face Encounter Date
  Date of the qualifying face-to-face encounter. It must be no more than 90 days before or within 30 days after the start of care date.
• Does the encounter fall within the required timing window?
  Confirm the encounter occurred within 90 days before or within 30 days after start of care.

Certifying Practitioner Information

• Practitioner Role
  Select the physician or allowed practitioner type.
• Practitioner Name
  Enter the practitioner name for the audit trail.
• NPI
  Enter the 10-digit National Provider Identifier.
• Practice Setting
  Select the setting where the encounter occurred.

Encounter Narrative

• Encounter Summary
  Briefly summarize the reason for the encounter, relevant findings, and why home health is needed.
• Homebound Status Support
  Describe the specific limitations that make leaving home a considerable and taxing effort, and any assistance required to leave the home.
• Skilled Need Support
  Describe the skilled nursing, therapy, or other skilled services needed and why they require professional care.

Documentation and Attestation

• Supporting Documentation Attached
  Select any supporting records included with this submission.
• Practitioner Attestation
  Required attestation for compliance documentation.
• Practitioner Signature
  Electronic signature of the certifying physician or allowed practitioner.
• Signature Date
  Date the practitioner signed the documentation.