RETIRED - In-person Visit Requirement for Section 6407 of the Affordable Care Act - Clarification

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.

Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Joint DME MAC Publication

Section 6407 of the Affordable Care Act (ACA 6407) requires that an in-person or face-to-face encounter must occur within the six months preceding the written order. There have been questions about whether this in-person visit must be conducted by the prescribing physician or whether an in in-person visit with another treating practitioner may be acceptable to fulfill this requirement.

CMS has clarified that the treating practitioner that conducted the face-to-face examination does not need to be the prescriber of the order for the DME item. However the prescriber must have knowledge and documentation of the face-to-face examination that was conducted.

Refer to the previously published bulletin and the applicable medical policy for additional information about ACA 6407.

This information will be updated in the previously published material.

Publication History

Date of Change Description
05/29/14 Originally Published
03/12/20 Retired due to CMS Final Rule 1713-F

 

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