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Fillable form fields
Enter certification, orders, goals, and plan-of-care information in the PDF.
Home health plan of care
CMS-485 fillable PDF
Complete the Home Health Certification and Plan of Care form, save a copy, and print the form and typed information together.
$59.95one-time product purchase
Type, save, and print the CMS-485 form.
Prepare a clear, reusable plan-of-care form
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Save completed copies
Keep a separate file for each completed form according to your recordkeeping procedures.
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Print on plain paper
Print the form and entered information together.
Important use note
The CMS-485 form records a patient’s home health certification and plan of care. The user is responsible for completing the form accurately and obtaining all required signatures and approvals.
Store completed forms using appropriate privacy and security controls.
Frequently asked questions
What is the CMS-485 form?
CMS-485 is the Home Health Certification and Plan of Care form used to document home health services and orders.
Can I save and print completed forms?
Yes. Enter the information, save a separate copy, and print the completed form.
Is this the same as the CMS-1500 software?
No. The CMS-485 product is a fillable PDF for the Home Health Certification and Plan of Care form.