OASIS Alert

The visit timing is critical.

Question: We have a patient who was admitted with orders for physical and occupational therapy evaluations. She was admitted by the nurse, who did the OASIS assessment. The OT visited and wants to continue to provide therapy, which the physician has ordered. The PT then visited and doesn't believe PT would be helpful at this time. Can OT continue to provide services under the Medicare home health benefit if no qualifying service (RN, PT or speech therapy) is currently involved?

Answer: It sounds as if the patient does qualify for continuing OT, says Mary St. Pierre with the National Association for Home Care & Hospice. The Centers for Medicare & Medicaid Services requires that there be OT orders and at least one visit by a qualifying service (either PT or SLP, because a single RN visit is not considered a qualifying visit) after one or more OT visits, St. Pierre explains. So the PT visit that followed the OT visit in this case would fit the requirements.

Of course, the initial assessment visit to confirm Medicare eligibility must take place before the OT visit, and that did occur in this case.