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 neurologic deficit — weakness, ataxia, or impaired balance — that makes leaving home unsafe without the assistance of another person and a device.
Impaired mobility from a stroke or other neurologic condition requiring assistance.
A cognitive or sensory deficit from the neurologic condition that makes leaving home unsafe alone.
The considerable and taxing effort required to leave home given the neurologic limitation.
Homebound paragraph — example
Patient remains homebound. A neurologic deficit with weakness and impaired balance makes leaving the home unsafe without the assistance of another person and a device, and the patient cannot safely manage steps and distance independently. Leaving the home requires assistance and considerable effort. Leaving home therefore requires a considerable and taxing effort.
