How should physicians sign home care plan of care recertifications?

This resource is part of the AMA's Debunking Regulatory Myths series, supporting AMA's practice transformation efforts to provide physicians and their care teams with resources to reduce guesswork and administrative burdens.

Physicians are required to sign every single page of home health agency plan of care (POC) certifications and recertifications.

There is no CMS requirement specifying that physicians or allowed non-physician practitioners must sign every single page of home health POC certifications or recertifications. The format of the document and the way in which timely certification or recertification is obtained is left to the determination of the individual home health agency.

When certifying and recertifying home health POCs, physicians and allowed non-physician practitioners (nurse practitioners, clinical nurse specialists, and physician assistants) are often met with conflicting instructions regarding how they should sign the document. Signing and dating every page of a home health certification or recertification can unnecessarily add administrative work and consume time.

1. Medicare General Information, Eligibility, and Entitlement: Physician Certification and Recertification of Services. Accessed July 2022.
2. Complying with Medicare Signature Requirements MLN Fact Sheet. Accessed July 2022.
3. Download the myth: How should physicians sign home care plan of care recertifications? (PDF)

1. Centers for Medicare and Medicaid Services. Physician Certification and Recertification of Services. In: Medicare General Information, Eligibility, and Entitlement.; 2021. Accessed August 31, 2022. https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/ge101c04.pdf
2. Centers for Medicare and Medicaid Services. Chapter 7: Home Health Services. In: Medicare Benefit Policy Manual.; 2022. Accessed August 31, 2022. https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c07.pdf

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Disclaimer: The AMA's Debunking Regulatory Myths (DRM) series is intended to convey general information only, based on guidance issued by applicable regulatory agencies, and not to provide legal advice or opinions. The contents within DRM should not be construed as, and should not be relied upon for, legal advice in any particular circumstance or fact situation. An attorney should be contacted for advice on specific legal issues. Additionally, all applicable laws and accreditation standards should be considered when applying information to your own practice.

Page last reviewed in October 2022.