CMS Releases Plans for Medical Review of the F2F Requirement

Members | June 01, 2015

The Centers for Medicare and Medicaid Services (CMS) has issued its initial plan for medical review of the home health face-to-face (F2F) encounter requirement. CMS will conduct prepayment reviews of home health claims for episodes beginning on or after August 1, 2015.

The Centers for Medicare and Medicaid Services (CMS) has issued its initial plan for medical review of the home health face-to-face (F2F) encounter requirement.  

CMS will conduct prepayment reviews of home health claims using a "Probe and Educate Review" process beginning Oct. 1, 2015. These reviews will impact claims with a "from" date beginning Aug. 1, 2015.  

The purpose of this Probe and Educate process is to ensure that home health agencies understand the new patient certification requirements.  

Because home health episodes have a 60-day certification, CMS anticipates the first documentation requests will be sent on or about October 1, 2015. 

CMS plans to provide additional details and information on the Probe and Educate process in the near future.