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
Dizziness or orthostatic instability from fluid imbalance that makes leaving home unsafe without assistance.
Weakness and reduced endurance from dehydration or overload.
A cognitive or functional limitation on independently obtaining fluids that requires support.
The need for frequent skilled assessment of an unstable fluid status.
Homebound paragraph — example
Patient remains homebound. Episodes of dizziness from fluid imbalance and generalized weakness limit safe mobility, and the patient requires the assistance of another person and a device for ambulation; obtaining fluids independently is limited. The fluid status is being closely monitored and managed. Leaving home therefore requires a considerable and taxing effort.
