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
Cognitive impairment that makes leaving home unsafe without the supervision of another person.
Disorientation or a wandering risk that requires supervision for safe mobility.
An inability to manage the demands of leaving home independently because of cognitive limitation.
The considerable and taxing effort and supervision required to leave home safely.
Homebound paragraph — example
Patient remains homebound. Cognitive impairment with disorientation makes leaving the home unsafe without the supervision of another person, and the patient cannot independently manage the navigation and judgment that leaving home requires. Supervision and considerable effort are needed for any outing. Leaving home therefore requires a considerable and taxing effort.
