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
Immobility and the pressure-injury risk it creates that require assistance and limit leaving home safely.
A skin condition or its management that, with weakness, requires assistance for safe mobility.
A need for frequent repositioning and skilled skin monitoring.
The considerable and taxing effort required to leave home given the underlying condition.
Homebound paragraph — example
Patient remains homebound. Immobility with a high pressure-injury risk requires assistance and frequent repositioning, and the patient needs the assistance of another person and a device for safe mobility; leaving the home is exhausting and not feasible without support. Leaving home therefore requires a considerable and taxing effort.
