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Medicare Face-to-Face Requirement

Medicare is now requiring documentation of a Face-to-Face (F2F) encounter for coverage of certain DME products.

CLICK HERE for pdf further outlining the regulation

The Medicare regulation, which is provided in its entirety below, stipulates the following;

The face-to-face encounter conducted by the physician, PA, NP, or CNS must document that the beneficiary was evaluated and/or treated for a condition that supports the item(s) of DME ordered.
In the case of a DME ordered by a PA, NP, or CNS, a physician (MD or DO) must document the occurrence of a face-to-face encounter by signing/co-signing and dating the pertinent portion of the medical record.
The written order for the DME must include, at a minimum;
1. the beneficiary's name,
2. the item of DME ordered,
3. the prescribing practitioner's National Provider Identifier (NPI),
4. the signature of the ordering practitioner and
5. the date of the order.
Failure to meet any of the above requirements will result in denial of the claim.
Physicians will be provided an additional payment, using code G0454, for signing/co-signing the face-to-face encounter of the PA/NP/CNS. The physician should not bill the G code when he/she conducts the face-to-face encounter. Note that the G code may only be paid to the physician one time per beneficiary per encounter, regardless of the number of covered items documented in the face-to-face encounter.

The full text of the regulation can be viewed by clicking here

We appreciate your assistance as we work together to provide the most beneficial healthcare solutions possible for your patients, in a manner that is consistent with the regulatory guidelines we are bound by.