• An actual encounter or virtual visit between the patient and the certifying physician (or NPP, NP, PA working with the certifying physician)
• NOTE: Virtual visits must include audio and video
• If a patient transfers from hospital to SNF, then F2F must come from SNF
• F2F visits cannot be done by a physician office partner. It must be done by the signing provider/NP/PA.

F2F must be:

• within 90 days prior to the home health SOC visit OR
• within the first 30 days after home health SOC

• Diagnosis (Primary Focus of Care): A physician-verified diagnosis is determined by the SOC clinician to be the chief reason the patient requires homecare. The reason/diagnosis for home care admission must be directly related to the care provided at the F2F visit.
• Homebound Status: Documentation must show a clinically consistent picture demonstrating the patient’s homecare eligiblity and WHY the patient is homebound.
• Skilled Need: Documentation must support the patient’s need for skilled services. What are the patient’s specific signs and symptoms and what home health can DO to help with the problem?

Primary Diagnosis/Primary Focus of Care must be directly related to the reason the home health agency is seeing the patient.

Progress Note must:

• Describe the patient’s condition and symptoms, not just a list of diagnoses
• Describe the reason for Home Health services as a new problem or an exacerbation of a previous problem (Listing a date or history of is not adequate to support an exacerbation)
• Describe any functional limitation and activity restrictions (assistive devices)
• Describe WHY skilled nursing and/or therapy is needed

Physician Visit: Patient was treated for cough with a diagnosis of bronchitis.

485: Primary diagnosis is hyptertension.

This physician visit does not qualify as a F2F visit because the focus of care/diagnoses do not align.

Patient is homebound due to taxing effort to leave home.

Patient leaves home with taxing effort due to extreme SOB d/t chronic COPD and emphysema.