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US · guidance

CMS Pub. 100-08, ch. 6, § 6.2.5

Medical Necessity of Services Provided

activein force · 2026-08-25 – presentas-observed

In addition to certification and recertification requirement documentation, contractors

shall also review the medical record documentation to determine whether services

provided were medically necessary. Again, home health generated information must be

reviewed, signed off by the certifying physician and incorporated into the certifying

physician medical record for the patient or the acute/post-acute care facility’s medical

record for the patient (if the patient was directly admitted to home health) if used to

support certification/recertification.

History

(Rev. 603, Issued: 07-21-15, Effective: 08-11-15, Implementation: 08-11-15)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
c88d23461c50804bbc168c656bf1b3bbee5601231c78b01a624e2ea5a4580632
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