CMS Pub. 100-02, ch. 7, § 30.5.2

At the end of the 60-day certification, a decision must be made whether or not to recertify

the patient for a subsequent 60-days. An eligible beneficiary who qualifies for a

subsequent 60-day certification would start the subsequent 60-day certification on day 61.

Under HH PPS, the plan of care must be reviewed and signed by the physician or allowed

practitioner every 60 days unless one of the following occurs:

• A beneficiary transfers to another HHA; or

• A discharge and return to home health during the 60-day certification.

For recertification of home health services, the physician or allowed practitioner must

certify (attest) that:

1. The home health services are or were needed because the patient is or was

confined to the home as defined in §30.1;

2. The patient needs or needed skilled nursing services on an intermittent basis (other

than solely venipuncture for the purposes of obtaining a blood sample), or physical

therapy, or speech-language pathology services; or continues to need occupational

therapy after the need for skilled nursing care, physical therapy, or speech-language

pathology services ceased. Where a patient’s sole skilled service need is for skilled

oversight of unskilled services (management and evaluation of the care plan as

defined in §40.1.2.2), the physician or allowed practitioner must include a brief

narrative describing the clinical justification of this need as part of the recertification,

or as a signed addendum to the recertification;

3. A plan of care has been established and is periodically reviewed by a physician or

allowed practitioner; and

4. The services are or were furnished while the patient is or was under the care of a

physician or allowed practitioner.

Medicare does not limit the number of continuous 60-day recertifications for

beneficiaries who continue to be eligible for the home health benefit. The certification

may cover a period less than but not greater than 60 days. Because the updated home

health plan of care must include the frequency and duration of visits to be made, the

physician or allowed practitioner does not have to estimate how much longer skilled

services will be needed for the recertification.