Medicare Face-to-Face Requirements

For certain specified items of durable medical equipment, the Affordable Care Act requires:

An in-person, face-to-face examination with the treating practitioner (Medical Doctor (MD), Doctor of Osteopathic Medicine (DO) or Doctor of Podiatric Medicine (DPM), physician assistant (PA), nurse practitioner (NP) or clinical nurse specialist (CNS))* and,
The treating practitioner must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the item(s) of DME ordered; and,

The face-to-face examination must have occurred sometime during the six (6) months prior to the date of the order for the item.

For a quick reference guide on face-to-face evaluations click here.