Medicare Benefit Policy Manual-Chapter 7 30.1.1


Attention All Ordering Providers:
The Medicare Benefit Policy Manual Chapter 7 30.1.1
Patient Confined to Home requires that Medicare beneficiaries
meet two sets of criteria before they be considered confined to the home (homebound):

1st Criteria:
The individual must either: Because of illness or injury, need the aid of supportive devices such as crutches, canes, wheelchairs and walkers; the use of special transportation; or the assistance of another person in order to leave their place of residence
Have a condition such that leaving his or her home is medically contraindicated (should be avoided).

2nd Criteria:
Then, if one of the above criteria is met, the individual must meet two additional requirements.
There must exist a normal inability to leave home;
Leaving home must require a considerable and taxing effort.

However, if the patient does in fact leave the home, the patient may still be considered homebound if the absences are infrequent and for relatively short duration (i.e., attend religious services, get a haircut, funeral, etc.) or are necessary in order to receive health care treatment. An aged person who does not often travel from home because of feebleness and insecurity brought on by advanced age would not be considered homebound unless they meet the criterial outlined above.

*Bio-Care will provide home laboratory services for patients who are deemed homebound by their healthcare provider. If the patient is not homebound, but would still like Bio-Care Services to provide home phlebotomy services, a nominal fee will be collected for the house call. The testing and draw fee (if applicable) will be billed to the patient’s insurance.