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CMS Revises Home Visit Documentation Requirements




CMS Revises Home Visit Documentation Requirements

The Centers for Medicare & Medicaid Services (CMS) announced in the 2019 Physician Fee Schedule Final Rule that it will eliminate some home visit documentation requirements.

Payment rates for E/M visits in the patient’s private residence (99341-99350) are marginally higher than those for the equivalent office-based visits. In previous years, home visit documentation had to justify the medical necessity of a home visit made in lieu of a (less expensive) office or outpatient visit. As part of an ongoing effort to lessen providers’ administrative burden when documenting E/M services, CMS proposed earlier this year to scrap this requirement.

Evaluation and Management – CEMC

Commenters supported the move, suggesting “that whether a visit occurs in the home or the office is best determined by the practitioner and the patient without applying additional rules.” CMS agreed, and per the Final Rule has finalizing a policy change to remove the requirement that the medical record must document the medical necessity of furnishing the visit in the home rather than in the office, as proposed, effective January 1, 2019.