In Medicare criteria for HEN, permanence is determined by whom and documented in the medical record?

• A. Nurse
• B. Dietitian
• C. Social worker
• D. Attending physician

Answer: (D)

The attending physician makes the determination that the need for home enteral nutrition is permanent and records that judgment in the medical record. In Medicare guidelines, this physician-certified assessment of ongoing, long-term need is the essential medical justification for HEN coverage. While other team members (nutritionists, nurses, social workers) contribute assessments and support, they do not certify permanence for Medicare purposes; the physician’s documentation provides the official basis for continued nutrition support and billing.