homebound status required for Medicaid?

I'm hoping some of you can help clarify this. I have conflicting information about whether Medicaid (Medi-Cal since we're in California) requires home health patients to be homebound. I've heard that it is not required, but then had a complaint and a state survey triggered because of a Medicaid patient who was questionably homebound. Our biller says that the billing manual seems to indicate that they should be homebound.

Please let me know if you have any information about this, and if possible, please include a source for it.

Thank you in advance for any help!

Laura Franklin


  • edited April 2017
    I have not seen any changes to the regs requiring homebound status for Medicaid/Medical patients.

    Karen Smith, RN, COS-C
    Resource Group
    Horizon Home Health
  • edited April 2017
    You need to check you state regs. Mcr requires that the patient be homebound and leaving home for outings of infrequent, short duration must be a considerable and taxing effort. You can check the mcr benefit manual for the full reg. States cannot mimic the federal reg verbatim, yet most require some degree of homebound.
Sign In or Register to comment.