How to Choose a Home Health Care Provider That Provides Therapy?

Among the many benefits that Medicare offers, home health care is one of the most valuable to older adults and their families. Sometimes people need extra monitoring due to a change in their disease or condition, if they’ve had surgery, or been in the hospital because of an illness or injury.

As part of home health care coverage, Medicare does pay for therapy visits. This article explains which types of therapy Medicare covers, how to choose a home health care provider, the basic eligibility rules, and how long therapy visits may continue.

What to Look for in a Home Health Care Provider That Offers Therapy

Finding the right home health care provider starts with understanding what Medicare covers. Medicare includes therapy as part of its home health care benefit when a doctor orders services for a specific health condition. These therapy visits help patients regain strength, increase mobility, and restore daily function in familiar surroundings.

What is Home Health Care?

Home health care is a service covered by most insurance plans, including Medicare. It involves sending licensed medical professionals into a patient’s home under the supervision of the patient’s doctor. The physician orders services based on the patient’s condition and care needs. This can happen during a routine office visit or as part of a hospital discharge plan.

Services provided under home health care can include:

Skilled nursing
Physical therapy
Speech Therapy
Occupational therapy
Home health aide services
Medical social work

How Do Patients Receive Therapy Under Medicare?

Patients are eligible for physical or occupational therapy as long as they meet the requirements for home health care. The requirements for home health care, in general, are that:

A patient must be under the care of a physician who certifies that the patient is homebound and has a regularly reviewed plan of care for in-home services.

Patients are considered homebound if they can’t leave their home without the help of special transportation, a walker, a cane, crutches, or without the help of another person. Not being able to leave the house due to illness and injury also qualifies as being homebound.

Patients may still qualify as homebound even if they leave the house for doctor visits, medical treatments, religious services, or adult day care.

What to Know About Medicare Requirements for Therapy

Medicare has very specific requirements for patients to receive therapy services at home. In the case of therapy, a patient must receive therapy treatment that is specific, safe, and effective for their condition.

A qualified therapist must perform the therapy, and the duration of home therapy must be deemed reasonable. This includes overall time spent in home care and how often therapy services are received during the time that the plan of treatment is good for.

To be eligible for services, patients must meet one of the following criteria:

The patient’s condition should show progress in a predictable timeframe.
A skilled therapist has to make a safe and effective maintenance program for the condition.
A skilled therapist has to complete safe and effective maintenance therapy for the condition.
The home care agency providing therapy services must be Medicare-certified.

Are There Limits on the Number of Therapy Visits Covered?

Medicare does not place a fixed cap on the number of therapy visits a patient may receive. However, total therapy costs are reviewed if spending exceeds a set threshold determined by Medicare. As long as therapy remains medically necessary and meets eligibility rules, coverage continues.

Home health care is an invaluable benefit for patients and their families. A dependable home health care provider makes therapy at home easier for patients and families who want safe, secure progress in familiar surroundings.

Voyager Home Health Care is a Medicare-certified agency that provides the best home health care experience for patients in and around Denver, CO, and Colorado Springs, CO. We also guide families through Colorado’s IHSS and CHCBS programs while bringing care, communication, and helpful support to every household. Reach out to us today to find out how you can obtain our services.

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