1. Is the Patient confined to his home?
In order for an individual to be eligible to receive covered home care services under Medicare, the law requires that a physician certify that the individual is homebound. An individual does not have to be bedridden to be considered homebound. However, the condition of the patient should be such that there exists a normal inability to leave home and, consequently, leaving the home requires a considerable and taxing effort.
2. The patient must need the skilled health services of a nurse or therapist.
3. Services must be ordered by a physician.
4. Services are reasonable and necessary to the treatment of illness or injury.
5. Frequency of visits is determined by individual need and must be intermittent...