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 communication impairment that, with the underlying condition, makes leaving home unsafe without assistance.
A sensory or speech limitation that requires the support of another person to communicate outside the home.
An inability to communicate needs or summon help independently outside the home.
The considerable and taxing effort required to leave home given the communication and associated limitations.
Homebound paragraph — example
Patient remains homebound. A communication impairment, together with the underlying condition, means the patient cannot reliably communicate needs or summon help independently outside the home and requires the assistance of another person; leaving the home requires assistance and considerable effort. Leaving home therefore requires a considerable and taxing effort.
