Form 485 Home Health. Provider's name, address and telephone number 4. Patient's name and address 7.
Cms 485 ≡ Fill Out Printable PDF Forms Online
I certify/recertify that this patient is confined to his/her home and needs intermittent skilled nursing care, physical therapy and/or speech therapy or continues to need occupational therapy. 42 cfr 424.22(a)(2) requires the certification of need for home. Web home health certification and plan of care. Web home health certification and plan of care 1. Provider's name, address and telephone number 4. Provider's name, address and telephone number 4. Patient's name and address 7. Start of care date 3. Start of care date 3. Patient's name and address 7.
Web home health certification and plan of care 1. Provider's name, address and telephone number 4. Web home health certification and plan of care. Start of care date 3. Patient's name and address 7. Provider's name, address and telephone number 4. Start of care date 3. I certify/recertify that this patient is confined to his/her home and needs intermittent skilled nursing care, physical therapy and/or speech therapy or continues to need occupational therapy. Web 42 cfr 424.22 requires that as a physician certification in order to pay for home health services under medicare part a or medicare part b. Web home health certification and plan of care 1. 42 cfr 424.22(a)(2) requires the certification of need for home.
