Ask CAHSAH | November 2025
For Medicare home health, can a prior face to face visit be used for a new case if the reason is still valid?
Medicare Home Health – Face-to-Face (F2F) Encounter Reuse Rules
This reference summarizes CMS regulations on when a prior face-to-face (F2F) encounter can be used for a new or ongoing Medicare home health case.
Regulatory Citation
42 CFR §424.22(a)(1) — Requirements for home health services: Physician certification and face-to-face encounter
“As part of the certification of eligibility, a physician must document that the physician himself or herself, or an allowed nonphysician practitioner (NPP), had a face-to-face encounter with the patient related to the primary reason the patient requires home health services, occurring no more than 90 days before or within 30 days after the start of the home health episode of care.”
Medicare Benefit Policy Manual
CMS Publication 100-02, Chapter 7, Section 30.5.1.1
“The same face-to-face encounter documentation may be used for recertification if the patient’s condition has not changed and the encounter occurred within the required timeframes. However, if a new condition or a significant change in the patient’s status necessitates home health care, a new face-to-face encounter must occur.”
Summary Table
|
Situation |
Can Prior F2F Be Used? |
Rule |
|
Same diagnosis/reason, within 90 days before or 30 days after SOC |
Yes |
42 CFR §424.22(a)(1); MBPM Ch.7 §30.5.1.1 |
|
Different diagnosis or reason for care |
No |
MBPM Ch.7 §30.5.1.1 |
|
F2F more than 90 days before SOC |
No |
42 CFR §424.22(a)(1) |
|
Recertification for same ongoing condition |
Yes |
MBPM Ch.7 §30.5.1.1 |
SOC = Start of Care
Summary
A prior F2F encounter can be reused for a new home health case only if the reason for home health services remains the same and the encounter occurred within the 90 days before or 30 days after the new start of care. Otherwise, a new encounter is required.