Face-to-face encounter.

In plain English

In Medicare's rules for durable medical equipment, a face-to-face encounter is an in-person or telehealth encounter between the treating practitioner and the patient. For power mobility devices and other items CMS has selected for its Required Face-to-Face Encounter and Written Order Prior to Delivery List, the practitioner must document and tell the supplier that the encounter happened within the 6 months before the written order. The encounter has to be for gathering information to diagnose, treat, or manage the condition the equipment is ordered for, and a telehealth encounter has to meet Medicare's telehealth rules. The treating practitioner can be a physician, physician assistant, nurse practitioner, or clinical nurse specialist. For items on that list, the written order also has to reach the supplier before delivery.

01Why it matters

The requirement is a condition of payment, so missing the visit or its timing is a paperwork gap with a money consequence. It applies only to items on the selected list, and that list changes when CMS announces new selections, so a requirement that did not apply to a piece of equipment last year can apply now.

02The math, step by step

A doctor sees a patient by video in March about worsening mobility and orders a power wheelchair in July. The visit falls within the 6 months before the order and was about the condition the chair is for, so it can satisfy the requirement, provided the video visit met Medicare's telehealth rules and the doctor documents it and tells the supplier.

Illustrative example. The amounts here are hypothetical, chosen to show how the math works, not real quoted rates or figures.

03What this is NOT

04Receipts

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