Question: Is a patient who is voluntarily self quarantined due to the pandemic considered homebound? It seems they would be since leaving the home is contraindicated at this time.

Answer: NAHC has reached out to CMS regarding possible flexibility regarding the homebound requirement in light of COVID-19. However, nothing has changed as of yet, and a patient quarantined to the home due to COVID-19 must still meet the existing homebound requirements (copied below from Chapter 7 of the Medicare Benefit Policy Manual for convenience) for payment from Medicare. Each case needs to be evaluated against these criterion, of course, but in general, COVID-19 or a person under investigation for COVID-19, alone may not result in qualifying a patient as homebound. We’ll let you know if anything changes in regards to homebound criterion.

  1. Criterion One: The patient 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  OR – Have a condition such that leaving his or her home is medically contraindicated.

If the patient meets one of the criterion one conditions, then the patient must ALSO meet two additional requirements defined in criterion two below.

  1. Criterion Two: There must exist a normal inability to leave home; AND – Leaving home must require a considerable and taxing effort.