ELIGIBILITY REQUIREMENTS (all must be met):
  1. Physician certifies patient is homebound
     Homebound = leaving home requires considerable/taxing effort
     Allowed: brief, infrequent absences for medical appointments, religious services
     
  2. Need for skilled care:
     Skilled nursing (wound care, injections, patient education, complex medication management)
     Physical therapy, occupational therapy, or speech-language pathology
     NOT: custodial care only (bathing, dressing assistance without skilled need)
     
  3. Services provided by Medicare-certified home health agency
  
  4. Physician orders home health (face-to-face encounter requirement)
     F2F encounter within 90 days before or 30 days after start of care
     Certifying physician must document clinical findings supporting homebound status and skilled need

COVERED SERVICES:
  Skilled nursing visits (most common)
  Physical therapy | Occupational therapy | Speech-language pathology
  Medical social work | Home health aide (only if also receiving skilled service)
  
NOT COVERED:
  24-hour-a-day care | Meals delivered to home
  Homemaker services | Personal care when no skilled need
  Custodial care (bathing, dressing) without skilled nursing or therapy need

OASIS (Outcome and Assessment Information Set):
  Required for all Medicare home health patients
  Comprehensive clinical assessment (100+ data items)
  Completed by: registered nurse or therapist
  Submitted to CMS via state agency software
  
  OASIS TIMEPOINTS:
    SOC (Start of Care): within 5 days of admission
    ROC (Resumption of Care): after inpatient stay
    FU (Follow-up): 60 days after SOC/ROC (if still on service)
    Transfer to inpatient
    DC (Discharge): at end of care

PLAN OF CARE (485 Form):
  Physician-ordered care plan for 60-day certification period
  Includes: diagnoses, medications, treatments, goals, frequency of visits
  Must be signed by physician before billing

CLINICAL RECORD:
  Visit notes for each clinical visit
  Support skilled need and homebound status
  Must corroborate OASIS findings and coded diagnoses