Home Health & Hospice Week

Reader Question:

Say Yes To At-Home Outpatient Treatment -- Sometimes

Tip: For Part B therapy, document why you're furnishing it in the home.

Question: Can we furnish therapy in the home to patients who are no longer homebound?

Answer: Yes, Medicare allows therapists to "treat patients in their homes as outpatients," says physical therapist Rick Gawenda, president of Gawenda Seminars & Consulting in Detroit.

Providing therapy to patients in their homes is a "highly valuable service to the community," says PT Tom Howell of Howell Physical Therapy in Eagle, Ind.

Remember: If patients are under a home health agency plan of care, you can't receive separate reimbursement for Part B therapy, Howell says. Once the discharge is done (and in writing), you can begin Part B therapy.

If you are having contract therapists perform the service who also work in a clinic setting, Howell suggests scheduling at-home therapy for early morning or late afternoon sessions so your therapists can work with them on the way to or from work. And therapists should always carry a "travel kit" that includes everything they might need so that no one is traveling back and forth unnecessarily.

Important: While Part B pays for at-home outpatient therapy, you should still thoroughly document your reasoning for working with patients at home, Howell advises. You can simply jot down the problem, whether it's that a client doesn't have reliable transportation, is in severe pain that limits mobility, or another factor.

Bottom line: As always, check with applicable state laws and your conditions of participation, Gawenda stresses. If they say you're clear for athome outpatient treatment, you can begin seeing patients in their homes immediately. Those using the 1500 claim form will simply choose place of service code 12 to signify the location.

HHAs can bill for the Part B therapy using HCPCS codes on Part A claims, notes regional home health intermediary Palmetto GBA on its website.

Note: For a free copy of Palmetto GBA's Home Health Outpatient Therapy job aide, e-mail editor Rebecca Johnson at rebeccaj@eliresearch. com with "OPT Job Aide" in the subject line.

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