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
Hemodynamic or orthostatic instability that makes leaving home medically unsafe without assistance.
A condition requiring frequent skilled vital-sign monitoring and parameter-based intervention.
Symptomatic episodes (dizziness, near-syncope) on activity that limit safe ambulation.
Dependence on another person or a device for safe mobility related to the monitored condition.
Homebound paragraph — example
Patient remains homebound. Has experienced symptomatic orthostatic drops with standing and requires the assistance of another person and a walker for safe ambulation; episodes of dizziness limit independent mobility. Leaving the home requires assistance and considerable effort, and the underlying instability requires frequent skilled monitoring and parameter-based intervention. Leaving home therefore requires a considerable and taxing effort.
