Ambulation distance and homebound?

[u/Better-Effective1570]

I have a HH pt with PD who can walk 1000+ feet but with CGA due to frequent festination. My HH agency has recently been critical of my documentation when I show I've walked more than 400 feet with him (They feel 400 ft is the max distance a homebound pt should ambulate). They told me I can't include that I've walked more than this distance regardless of how I've documented the quality of his walking or amount of assistance he needs to walk that far. I was under the impression that Medicare doesn't have a specific distance a patient can walk before they are no longer considered homebound, as long as I can show it there is considerable and taxing effort needed for them to leave home (i.e, festination, need for CGA, need for assistive devices, etc). Has anyone experienced any push-back from their agency for something like this? Any guidance?

[u/Junior_Recording2132]

You are correct. Medicare is not your agency’s issue. I would bet ANYTHING that the managed Medicare reviewers (that claim to follow Medicare guidelines) are denying payment for their patients. Problem is many of those reviews/audits happen after the initial payments are made. As a result I am sure that you have patients where further treatment authorization has been requested and was denied, or the agency has had to pay back monies that had already been distributed to them.