Medicare Face-to-Face Evaluation

The face-to-face evaluation must be performed by the physician, NP, PA or CSN.

PLEASE NOTE:  If the face-to-face is being performed by someone other than the physician, it MUST be approved and signed by the physician upon completion.

The face-to-face evaluation must occur within six months prior to the written order.

The evaluating physician must document in the patient’s records the event of the face-to-face encounter.

The documentation in the medical records must include:

• Evaluation of the client
• Assessment of medical necessity

When the physician documents in the medical records, there must be adequate and sufficient evidence present to justify medical necessity.

The purpose of the visit must be for the requesting equipment or supplies.