How does Medicare define homebound status?
The Centers for Medicare and Medicaid Services (CMS) advises that an individual shall be considered “confined to the home” (homebound) if the following two criteria are met:
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 Criteria-One conditions, then the patient must also meet two additional requirements defined in Criteria-Two below.
There must exist a normal inability to leave home and leaving home must require a considerable and taxing effort.