Home Health Care Agencies

• A medical need such as new diagnoses or exacerbation of a disease type is required in order for services to be covered for either a registered nurse and/or physical therapist.
• A Medicare participant must be considered homebound where it is a taxing effort for them to leave their home.
• Home physical therapy is not as aggressive as outpatient physical therapy where equipment and weights can be utilized.  Home physical therapy is a great way to start care versus outpatient therapy as a patient can benefit from a visiting nurse to monitor their health at home.
• Medical supplies such as wound care bandages are covered under Medicare and the visiting nurse will bring supplies.
• There is no co-pay or out of pocket expense for Medicare home health.
• Medicare does NOT pay for custodial care, assistance with daily living or companionship. It is good to know however a physician can request a home health aide to assist with bathing up to three times a week under Medicare.
• Although your physician may suggest a particular home health care agency, under Medicare guidelines it is patient’s choice as to which provider they wish to allow in their home.
• It is customary for the physician that sees patients in a skilled nursing and rehabilitation facility to order home health care upon discharge from their facility. The home health care nurse and/or physical therapist can help ensure safety and communicate care with the primary care physician for post rehabilitation follow up.
• Medicare home health can treat a resident in an assisted living facility, residential care home or home environment just as long as there is not a duplication of services.
• A Hospice organization has the ability to provide Medicare home health services where both Hospice and a Medicare Home Health Care Agency bill under Medicare Part A.

Should a patient elect outpatient physical therapy instead of home health care services, those services will be billed under Part B and there is a co-pay.