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Face-to-Face Encounter Required for Services by a Home Health Agency

March 6, 2018

Effective for dates of service on or after July 1, 2017, Code of Federal Regulations (CFR) Title 42, Section 440.70 requires Medicaid programs to require a face-to-face encounter prior to delivery of services by a home health agency. The face-to-face encounter must be administered by a physician, nurse practitioner, clinical nurse specialist, physician assistant or certified nurse midwife and must be related to the primary reason the recipient requires home health services. Face-to-face encounters may be done via telehealth. The encounter must occur within 90 days before or within 30 days after the start of services. If the provider performing the face-to-face encounter is not the physician, the provider must communicate the clinical findings of that face-to-face encounter to the ordering physician.

Updated manual pages reflecting this change will be released in a future Medi-Cal Update.