Medicare requires both prongs: the patient needs the aid of a supportive device or another person or has a condition that makes leaving home medically contraindicated, and leaving home requires a considerable and taxing effort. Document patient-specific evidence when homebound status is assessed, and ensure the longitudinal record continues to support both Medicare homebound criteria.
Evidence from this system that supports homebound status
A psychiatric condition severe enough that leaving home is not feasible without support or is medically inadvisable.
Severe anxiety, depression, or other symptoms that restrict the ability to leave home.
A safety consideration related to the mental-health condition that requires support to leave home.
The considerable and taxing effort required to leave home given the psychiatric condition.
Homebound paragraph — example
Patient remains homebound. The severity of the psychiatric condition restricts the ability to leave home — leaving requires the support of another person and is accomplished only with considerable difficulty — and symptoms limit independent functioning outside the home. Leaving home therefore requires a considerable and taxing effort.
