Eligibility is also based on the amount of services you need
If you meet the conditions above, Medicare pays for your covered home health services for as long as you’re eligible and your doctor certifies you need them. If you need more than part-time or “intermittent” skilled nursing care, you aren’t eligible for the home health benefit.
To decide whether you’re eligible for home health care, Medicare defines part-time or “intermittent” as skilled nursing care that’s needed or given on fewer than 7 days each week or less than 8 hours each day over a period of 21 days (or less) with some exceptions in special circumstances.
Hour and day limits may be extended in exceptional circumstances when your doctor can predict when your need for care will end.
Home health Billing Guide and process, CPT CODE, ICD CODE and how to get paid, dealing insurance denial.
Tuesday, January 11, 2011
How Medicare determine the home health service eligibility
Labels:
Eligibility,
Home health billing basic
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