Medicare: Documentation - Homebound status

Review Medicare criteria to consider a patient as a homebound patient. To find out details, read along!

For a patient to be eligible to receive covered home health services under both Part A and Part B, the law requires that a physician or allowed practitioner certify in all cases that the patient is confined to his/her home. For purposes of the statute, an individual shall be considered “confined to the home” (homebound) if the following two criteria are met:


         Criteria One

The patient must either:

-          Because of illness or injury, need the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person in order to leave their place of residence, OR

-          Have a condition such that leaving his or her home is medically contraindicated

If the patient meets one of the criteria one conditions, then the patient must also meet two additional requirements defined in criteria two below.

         Criteria Two

 -There must exist a normal inability to leave home; AND

- Leaving home must require a considerable and taxing effort


Sourcehttps://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf