At the start of care and when your condition changes, your home health agency should assess you to see what services you need. The home health agency should then develop a plan of care that spells out the type and amount of services that you need.  Your doctor must sign the plan of care at the start of your care or soon after it starts and at least every sixty days. The plan of care and certification will last up to sixty days. If you still need more care after that, the plan of care and certification can be renewed for as many 60-day periods as you need as long as your doctor signs them. A face-to-face meeting is not required for re-certification. 

It is important to make sure that doctor agrees with the plan of care and thinks it contains all the care you need. 

Note: The plan of care is often contained in the same form as the home health certification that your doctor must sign to show you need Medicare home care. As part of the certification for home health care, your doctor must confirm that you had a face-to-face meeting with him/her or other health care provider related to the main reason you need home care. This meeting must be within 90 days of starting to receive home health care or within 30 days after you have already started receiving home health care. Your physician must specifically state that the face-to-face meeting confirmed that you are homebound and qualify for intermittent skilled care

The face-to-face encounter can also be done through telehealth.  In certain areas, Medicare will cover examinations done for you in specific places (doctors offices, hospitals, health clinics) through the use of telecommunications (such as video conferencing). 

A face-to-face meeting is not required for re-certification.