Outpatient Therapy In an Assisted Living Facility
I receive many questions regarding treating Medicare beneficiaries for outpatient physical, occupational and/or speech therapy who reside in an assisted living facility (ALF). In this article, I will answer the following questions:
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Would the ALF be considered Medicare part A or part B?
If doing outpatient therapy, all outpatient therapy is reimbursed under Medicare Part B benefits.
Just wanted to clarify the reasoning for needing to pay fair-market value rent for that space. And can we have an agreement with the facility to use for free?
You can’t rent space for free. That could be viewed as anti-kickback or an inducement. You may want to contact a healthcare attorney.
When would it be appropriate to use place of service code 13 then, vs the service code 12?
In my opinion for outpatient therapy, never.
Regarding the answer to the above question about providing care in the common area of an ALF, does the same pertain to an independent living/retirement community? Thank you! – Alan
Yes