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08/23/21

Outpatient Therapy in the Home: FAQs

With an increase in private practices, especially solo practices, providing outpatient therapy in a patient’s home, I am receiving more and more questions regarding the regulatory, billing and payment rules. In addition, due to COVID-19, rehabilitation agencies and hospital outpatient therapy departments are sending their therapists to a patient’s home to provide outpatient therapy services. In this article, I will provide answers to the following questions: Does the Medicare program pay for outpatient therapy provided in a beneficiaries home? For Medicare purposes, what is considered a patient’s home? Do Medicare Advantage plans and commercial insurance carriers pay for outpatient therapy

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06/14/21

What is Considered a Patient’s Home

More and more physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) are establishing private practices that focus on seeing patients in their home for outpatient therapy services. The Centers for Medicare and Medicaid Services (CMS) does allow PTs, OTs, and SLPs to treat Medicare beneficiaries in their home as outpatients and pays for those services under the Medicare Physician Fee Schedule just as CMS would pay if the Medicare beneficiary went to a private practice or other outpatient therapy setting (except for a critical access hospital who is reimbursed on a cost-ratio basis). However, what is considered a

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04/19/20

Coronavirus and Therapy in the Home

Due to the coronavirus (COVID-19), I am receiving many questions regarding the ability for physical therapists, occupational therapists and speech-language pathologists to provide outpatient therapy services in a patient’s home and to have those services reimbursed by the Medicare program and private/commercial insurance carriers. See below for some of the common questions I receive and the answers to each question. This article was originally published on March 16, 2020, but I republished it today and added additional Q&As. QuestionDoes the Medicare program reimburse for outpatient therapy in a patient’s home? Answer QuestionWhat is considered a patient’s home? Answer QuestionWith the

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05/14/18

Can I Treat Patient’s in Their Home as an Outpatient

Whether an insurance carrier will pay for therapy services provided in the patient’s home under their outpatient therapy benefits is the answer most people do not like; it is insurance carrier specific. Regarding the Medicare program, the Centers for Medicare and Medicaid Services (CMS) states therapy services are payable under the Medicare Physician Fee Schedule when furnished by a provider or supplier in the following settings:

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