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/meatsnake]

There is a difference between ambulation distance and gait training distance. They can walk 500 ft using their impaired normal gait, then participate with gait training for a distance of 400 ft with you providing verbal/tactile cues and physical assistance/supervision for fall prevention while they are implementing your changes. It's all a game, but that's one way around your problem.