Physicians: 2 Key Home Health Care Areas CMS Needs to Address

Despite proposed changes to face-to-face requirements early last month, some say CMS’ inaction over the past several years has disproportionately affected the home health care sector, an article in Physicians Practice suggests.

CMS action in two key areas could benefit not just home health, but the industry as a whole: increasing reimbursement for home-based visits and allowing a nurse practitioner or physician assistant to certify patients.

Even amid cuts to home health payments, an increase in reimbursement for home-based visits would help in the long run, Physicians Practice notes.


“Immediately, it would solve a historic problem in the house-call space: upcoding, or variations of upcoming,” the article states. “These providers are working with some of the most complicated patients currently in the system. Many are elderly, frail, with three or more chronic conditions. The reimbursement should be more in line with that level of care.”

In addition, the industry could benefit from expanded coverage for telehealth, travel options and social worker resources, as these tools fall outside of the direct patient-provider relationship, but can be effective in managing home health patients and avoiding hospital readmissions, Physicians Practice suggests.

While CMS’ proposed changes in July seek to eliminate the narrative requirement in face-to-face encounter regulations beginning next year, the revision misses key focus areas.


“Not requiring a narrative for the initial face-to-face certification is helpful, but not as helpful as allowing a nurse practitioner or physician assistant to certify the patient,” the article states. “Currently, the nonphysician provider can fill out the face-to-face form, but the supervising physician has to execute the certification.”

Read the full Physicians Practice article here.

Written by Emily Study

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