Face-to-Face

Section 2207 (a) of the Full-Year Continuing Appropriations and Extensions Act 2025 extended the use of telecommunications technology for certifying a patient’s eligibility for the home health benefit, that the certifying physician must document, or an allowed non-physician practitioner (NPP), has had a face-to-face encounter with the patient. This extension is applicable through September 30, 2025, and temporary removes geographic requirements and expanding originating sites for telehealth services during the extension.

This article includes information about Denial Reason Code 5FF2F/5FFTF - Face-to-Face Encounter Requirements Not Met and how to prevent this denial.

This is a tool that can be used for teaching physicians/staff about the requirements of the home health face to face encounter or to evaluate the quality of face to face documents.

This article tells providers how and when to submit a claim for care plan oversight services and when the claims will be denied.

It is important to remember that all Medicare requirements must be met for claim payment. As a condition for payment, the Affordable Care Act mandates that prior to certifying a patient’s eligibility for the home health benefit, the certifying physician must document that he or she, or a qualified nonphysician practitioner (NPP), has had a face-to-face encounter with the patient. For initial home health certifications, the certifying physician must document that the physician, a qualified nonphysician practitioner (NPP), or a physician caring for the patient in an acute or post-acute facility, who has privileges at the facility, had a face-to-face encounter with the patient.

This article includes scenarios that meet the F2F encounter certification requirements.

This article includes the specific classes of information for the "actual clinical note for face-to-face encounter" which is required for compliant home health physician certifications.

Medicare has changed the physician documentation requirements for certification of home health care for dates of service effective January 1, 2015.

This article assist providers on how to use clinical visit notes to help support eligibility for home health services.

Palmetto GBA has been advising providers to include the face-to-face encounter documentation with all home health claims chosen for medical review.