Medicare Face-to-Face Example
What is it?
As a condition of payment, Insurance requires a physician document a Face-to-Face examination with a beneficiary prior to prescribing Durable Medical Equipment (DME). Speech generating devices are considered DME, and therefore, a recent physician’s visit must be on file within 6 months of the speech device prescription date.
When it's needed?
Anytime the patient has one of the following funding sources:
What is required?
The face to face notes must include the following:
Doctor’s Progress Notes; from a visit or exam related to the treatment of a communication disorder. The notes should give a brief background of the patient, his/her communication disorder and recommending the Speech Generating Device. See example below:
David Smith is a 47 year old male who was seen in the office for a Speech Generating Device. Patient has a diagnosis of ALS G12.21 and Dysarthria R47.1. Patient is currently communicating by gestures and facial expressions. The patient’s family and caregivers agree that this means of communication is not working. David is having trouble communicating with familiar and unfamiliar communication partners. David would benefit from a Speech Generating Device code E2510.
Signature; The face to face notes must be signed by the physician.
6 Month Recency; The documented visit must show recency within 6 months of the speech device prescription date.