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
Profound daytime fatigue from disrupted sleep that limits endurance for leaving home.
A medical contributor to disrupted sleep (for example nocturnal dyspnea) that itself supports homebound status.
Excessive daytime sleepiness that makes leaving home unsafe without assistance.
The need for frequent skilled assessment of the contributors to disrupted sleep.
Homebound paragraph — example
Patient remains homebound. Profound daytime fatigue from disrupted sleep, compounded by the underlying condition, limits endurance, and the patient requires assistance and a device for safe mobility; leaving the home is exhausting. The contributors to disrupted sleep are being assessed and managed. Leaving home therefore requires a considerable and taxing effort.
