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VNSNY PROVIDER SERVICES

POLICY

POLICY TITLE: FIRST VISIT
Number: CP.103
Applies To: Certified Home Health Agency
Policy Section: Home Health Aides
Page 2 of 4

visit determines homebound status/eligibility for the Medicare home health
benefits. This must be documented in the medical record.
3. The SN or PT (in PT only cases) makes the initial home visit within 24
hours of receipt and acceptance of a community referral or return home
from institutional placement unless:(1) the patient's authorized practitioner
orders otherwise; or (2) there is written documentation that the patient or
family refuses the visit.
4. In the instances where the patient requests a delay in the start of care date, the
Clinical Field Manager (CFM) or designee may contact the physician to request
a change in the start of care date. This change must be documented in the
medical records.

Plan of Care Visit Frequency Guidelines:

The Medicare work week for visit frequency is Sunday through Saturday.

Subsequent Service: First Visit

1. When an evaluation visit by another discipline is required an “ADD ON” visit is
scheduled.
2. In those cases, in which prior authorization of the service by a third- party payer
is required, the first visit by that service shall be contingent upon the entry of
authorization.
a. Therapy visits: On shared cases, the first PT, OT, ST visit is to be made
within 7 calendar days of the request for service as ordered in the plan of
care, unless the physician specifies otherwise.
b. Social Work If the referring professional deems the case urgent, the
visit is to be made within 7 calendar days of the request service as
noted in the plan of care.

3. If the professional visit cannot be made per guidelines above, both the
physician and patient should be informed with documentation of
notification of each in the coordination note. For Traditional Medicare
beneficiaries, a HHCCN may need to be issued.

Home Health Aide

Policy Owner: VNSNY Provider Services
Reviewed: VNSNY Provider Services Quality & Patient Safety
Approved: SVP, Intake and Patient Care Services
Revised: 9/30/14, 12/31/15 04/18/2016, 10/11/2016, 03/17/2017, 12/2018