Medicare Regulations for Home Health Supervisory Visits

What are Home Health Visits?

• Those with serious disease or injuries often avoid institutionalization by seeking out home health care. Home health visits are administered by home health agencies. The employees of the home health agencies perform medically necessary care such as therapies and nursing in the home, as well as personal care. Personal care includes bathing, dressing and feeding.
  
  

When Medicare Covers Visits

• Medicare will cover home health care visits if the patient is homebound. This means they require a considerable amount of assistance to move around, whether that means using a cane, wheelchair or the help of another person. Leaving the home to go to the doctors or for short periods to run errands would not disqualify someone as homebound. Furthermore, attending special events like weddings or ceremonies is allowable as well.
  
  The doctor must think the patient requires skilled nursing care and therapy. This includes physical, occupational and speech therapy. Finally, in order for Medicare to cover the home health care, it must be care supplied by an agency that is Medicare-certified.
  
  

Types of Care Covered

• The Medicare benefit covers home health supervisory visits from registered nurses or those under supervision of a registered nurse. The RN or assistant provides the skilled nursing care or therapy that the doctor requested. A skilled therapist can provide the physical, occupational or speech therapy. Medicare also covers care provided by any social services provider supervised by a doctor, and a supervised home health aide.
  
  

How Much Is Covered

• Generally, as long as you need home health care, Medicare will pay for it. However, Medicare does not cover round-the-clock care. Furthermore, your doctor must draft a plan of care every 60 days, reconfirming that you are in need of home health care and that you meet all of Medicare's eligibility requirements in order for you to continue receiving the home health care benefit.
  
  

How It's Covered

• How the home health agency visits are paid for depends on whether or not the beneficiary was in a skilled nursing facility (SNF) or a hospital before receiving the care. If the beneficiary was in the hospital or SNF for three or more consecutive days and he began the care within 14 days of discharge from the hospital or SNF, then Medicare Part A, the inpatient hospital benefit, pays for the first 100 days of coverage. From there, Medicare Part B pays the rest. If this is not the case, then Medicare Part B pays for the entirety of the stay.
  
  

Home Health Agency Rights

• A home health agency is not required to take a Medicare beneficiary on as a patient. If a home health agency is not equipped to provide services to a patient or if the agency determines that it is unable to keep the patient safe, then it does not have to accept the beneficiary as a patient.