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 need for the assistance of another person or a supportive device for transfers or ambulation.
Limited endurance or unsteady gait that makes leaving home unsafe without assistance.
An inability to manage the instrumental activities required to leave home independently.
The considerable and taxing effort required to leave home given the functional limitation.
Homebound paragraph — example
Patient remains homebound. Requires a one-person assist and a walker for transfers and ambulation, and gait is unsteady over more than a short distance; leaving the home requires the assistance of another person and prolonged effort, and the patient cannot manage the steps and distance involved independently. The most recent attempt to leave home for a medical appointment required two-person assistance and left the patient exhausted. Leaving home therefore requires a considerable and taxing effort.
