CMS Pub. 100-08, ch. 5, § 5.4.1

For DMEPOS items appearing on the Required Face-to-Face and Written Order Prior to

Delivery List, the treating practitioner must document and communicate to the DMEPOS

supplier that the treating practitioner has had a face-to-face encounter with

the beneficiary within the 6 months preceding the date of the written order/prescription.

A qualifying face-to-face encounter is required each time there is a new

order/prescription for a DMEPOS items on the Required Face-to-Face and Written Order

Prior to Delivery List. A single face-to-face encounter may document the clinical

conditions necessitating multiple DMEPOS items. In this situation, regardless of whether

the DMEPOS items are prescribed on different dates, the single face-to-face encounter

may be utilized in support of the multiple items, so long as the encounter date is within 6

months prior to the date of the orders. As always, the supplier is responsible for

submitting documentation to support each claim upon request. The exception to this

requirement is for items replaced with an identical item (same Healthcare Common

Procedure Coding System (HCPCS) code) following the expiration of the five-year

reasonable useful lifetime. In this circumstance, a new Face-to-Face evaluation would

not be required unless specifically required by a Local Coverage Determination or

National Coverage Determination.

The face-to-face requirement codified at 42 CFR 410.38 does not supplant other CMS

coverage policies.