Timeliness of Signature

30.2.5 - Timeliness of Signature (Rev. 10438, Issued: 11-06-20, Effective: 03-01-20, Implementation: 01- 11-21) A. Initial Percentage Payment If a physician or allowed practitioner signed plan of care is not available at the beginning of the 30-day period, the HHA may submit a RAP for the initial percentage payment based on physician or allowed practitioner verbal orders OR a referral prescribing detailed orders for the services to be rendered that is signed and dated by the physician or allowed practitioner. If the RAP submission is based on verbal orders, the verbal order must be recorded in the plan of care, include a description of the patient's condition and the services to be provided by the home health agency, include an attestation (relating to the physician's or allowed practitioner’s orders and the date received per 42 CFR 409.43), and the plan of care is copied and immediately submitted to the physician or allowed practitioner. A billable visit must be rendered prior to the submission of a RAP. B. Final Percentage Payment The plan of care must be signed and dated by a physician or allowed practitioner as described who meets the certification and recertification requirements of 42 CFR 424.22 and before the claim for each 30-day period for services is submitted for the final percentage payment. Any changes in the plan of care must be signed and dated by a physician or allowed practitioner.