Physician or Allowed Practitioner Recertification

30.5.2 - Physician or Allowed Practitioner Recertification (Rev. 10438, Issued: 11-06-20, Effective: 03-01-20, Implementation: 01- 11-21) At the end of the 60-day certification, a decision must be made whether or not to recertify the patient for a subsequent 60-days. An eligible beneficiary who qualifies for a subsequent 60-day certification would start the subsequent 60-day certification on day 61. Under HH PPS, the plan of care must be reviewed and signed by the physician or allowed practitioner every 60 days unless one of the following occurs: • A beneficiary transfers to another HHA; or • A discharge and return to home health during the 60-day certification. For recertification of home health services, the physician or allowed practitioner must certify (attest) that: 1. The home health services are or were needed because the patient is or was confined to the home as defined in §30.1; 2. The patient needs or needed skilled nursing services on an intermittent basis (other than solely venipuncture for the purposes of obtaining a blood sample), or physical therapy, or speech-language pathology services; or continues to need occupational therapy after the need for skilled nursing care, physical therapy, or speech-language pathology services ceased. Where a patient’s sole skilled service need is for skilled oversight of unskilled services (management and evaluation of the care plan as defined in §40.1.2.2), the physician or allowed practitioner must include a brief narrative describing the clinical justification of this need as part of the recertification, or as a signed addendum to the recertification; 3. A plan of care has been established and is periodically reviewed by a physician or allowed practitioner; and 4. The services are or were furnished while the patient is or was under the care of a physician or allowed practitioner. Medicare does not limit the number of continuous 60-day recertifications for beneficiaries who continue to be eligible for the home health benefit. The certification may cover a period less than but not greater than 60 days. Because the updated home health plan of care must include the frequency and duration of visits to be made, the physician or allowed practitioner does not have to estimate how much longer skilled services will be needed for the recertification.