Treatment Plans for Visiting Nursing Services

190.5 - Treatment Plans for Visiting Nursing Services (Rev. 12832; Issued: 09-12-24; Effective:01-01-24; Implementation:10-14-24) For services and supplies that require a treatment plan, the treatment plan must be written and reviewed by a supervising physician, NP, PA, CNM, CP, CSW, MFT, or MHC as appropriate, at least once every 60 days; and meet other documentation requirements. If the patient does not receive at least one covered nursing visit in a 60-day period, the plan is considered terminated for the purpose of Medicare coverage unless: • The supervising physician has reviewed the plan of treatment and made a recertification within the 60-day period which indicates that the lapse of visits is a part of the physician’s regimen for the patient, or • Nursing visits are required at intervals less frequently than once every 60 days, but the intervals are predictable (e.g., it is predictable that a visit is required only every 90 days for the purpose of changing a silicone catheter, etc.). Home nursing visits furnished before the plan is put into writing are covered if authorized in writing by the supervising physician.