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January 16, 2020; Revised February 21, 2022

Home Health Physician or Allowed Practitioner Certification Date

The certifying physician, allowed practitioner or allowed non-physician practitioner (NPP) must have a face-to-face encounter with the beneficiary before they certify the beneficiary’s eligibility for the home health benefit.

Example:

Face-to-Face encounter occurs November 1, 2020

Compliant

Certifying physician or allowed practitioner signs and dates the certification to the home health benefit November 5, 2020.

Non-Compliant

Certifying physician or allowed practitioner signs and dates the certification to the home health benefit October 30, 2020.

Example Certification Statement:

I certify that this patient is confined to his/her home and needs intermittent skilled nursing care, physical therapy and/or speech therapy or continues to need occupational therapy. The patient is under my care, and I have authorized services on this plan of care and will periodically review the plan. The patient had a face-to-face encounter with a physician or an allowed non-physician practitioner on 11/01/2020 and the encounter was related to the primary reason for home health care.

Physician's or allowed practitioner’s Signature and Date Signed: John Doe, MD 11/05/2020

Physician's or allowed practitioner’s Name and Address:

John Doe, MD
2121 Washington Pkwy
Suite 220
Washington, DC 20000

Reference:

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