CallMedicare Guidelines
01
Medicare Guidelines
In order to qualify for home health services under Medicare, the patient must:
- Be eligible for Medicare benefits
- Be under the care of a physician who establishes and periodically reviews the plan of care
In order to qualify for home health services under Medicare, the patient must:
In order to qualify for home health services under Medicare, the patient must:
- Be eligible for Medicare benefits
- Be under the care of a physician who establishes and periodically reviews the plan of care
- Require skilled nursing on an intermittent basis or physical, speech, or occupational therapy for ongoing services
- Require services reasonable and necessary for treatment of the illness or injury
- Be homebound
01
Medicare Guidelines
In order to qualify for home health services under Medicare, the patient must:
- Be eligible for Medicare benefits
- Be under the care of a physician who establishes and periodically reviews the plan of care
- Require skilled nursing on an intermittent basis or physical, speech, or occupational therapy for ongoing services
- Require services reasonable and necessary for treatment of the illness or injury
- Be homebound
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WE CARE.
02
How Do Patients Qualify?
- What does “homebound” really mean? Medicare defines it as: “absences from the home are infrequent, of short duration, a taxing effort or, to receive medical care.”
- What is a “qualifying skilled need”? If a patient has one of the diagnoses listed above, that is the skilled need. Any need for a Registered Nurse or Registered Therapist qualifies.
How Do Patients Qualify?
Reliance Home Health Care offers services for these conditions which includes but is not limited to:
02
How Do Patients Qualify?
Reliance Home Health Care offers services for these conditions which includes but is not limited to:
- What does “homebound” really mean? Medicare defines it as: “absences from the home are infrequent, of short duration, a taxing effort or, to receive medical care.”
- What is a “qualifying skilled need”? If a patient has one of the diagnoses listed above, that is the skilled need. Any need for a Registered Nurse or Registered Therapist qualifies.
- Does the patient need to be recently discharged from a facility? No. But a Medicare Certified Agency must have a physician’s agreement to sign orders.
- Medicare reimburses approved home care at 100%
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WE CARE.
03
NOW MEDICARE REMBURSES THE PHYSICIANS ALSO:
- USING CODE G0180: MEDICARE ALLOWABLE IS $56.51 for cert.
- USING CODE G0179: MEDICARE ALLOWABLE IS $43.32 for recert.
- USING CODE G0181: MEDICARE ALLOWABLE IS $113.62 for CPO.
NOW MEDICARE REMBURSES THE PHYSICIANS ALSO:
In order to qualify for home health services under Medicare, the patient must:
- Be eligible for Medicare benefits
- Be under the care of a physician who establishes and periodically reviews the plan of care
- Require skilled nursing on an intermittent basis or physical, speech, or occupational therapy for ongoing services
- Require services reasonable and necessary for treatment of the illness or injury
- Be homebound