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
An elevated fall risk that makes leaving home unsafe without the assistance of another person.
A need for assistance or a device for safe mobility related to the safety risk.
A cognitive or functional limitation that makes leaving home unsafe alone.
The considerable and taxing effort required to leave home given the safety limitation.
Homebound paragraph — example
Patient remains homebound. An elevated fall risk with an unsteady gait makes leaving the home unsafe without the assistance of another person and a device, and the patient cannot safely manage steps and uneven surfaces independently. Leaving the home requires assistance and considerable effort. Leaving home therefore requires a considerable and taxing effort.
