N.C. Medicaid Clinical Coverage Policy No. 3D, Attachment B(C)

1. Face-to-Face Encounter

A hospice physician or other Medicare-recognized provider who performs the encounter shall

attest in writing that he or she had a face-to-face encounter with the beneficiary, documenting

the date of the encounter. Note the following:

a. The attestation, its accompanying signature, and the date signed, must be a separate and

distinct section of, or an addendum to, the recertification form, and must be clearly titled.

b. Documentation is required for any exceptional circumstance that prevented the face-to-face

encounter from being conducted in a timely manner.

2. Attestation Statement for Non-Physician Practitioner

a. Where a Medicare-recognized non-physician provider performed the encounter, the

attestation must state that the clinical findings of that visit were provided to the certifying

physician, for use in determining whether the beneficiary continues to have a life

expectancy of six months or less, should the illness run its normal course.

b. Medicare-recognized non-physician hospice providers may conduct face-to-face encounters

as described in as part of the certification process but are still prohibited by statute from

certifying the terminal illness. If a beneficiary’s attending physician is a Medicare

recognized non-physician provider, the hospice medical director or physician designee may

certify or recertify the terminal illness.