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Home health access problems have ebbed and flowed over the years, depending on the reigning payment mechanisms, systemic pressures, and misinformation about Medicare home health coverage.  Regrettably, as we’ve been reporting, it seems access issue are on the upswing.  Here is the first of several Practice Tips to help maximize Medicare-covered home care under the law.

Medicare Home Health Coverage Can be Available for Daily Skilled Nursing

Medicare home health coverage can sometimes be available for daily skilled nursing. Medicare law authorizes coverage for daily skilled nursing under the home health benefit for less than 8 hours each day, for periods of 21 days or less.  Extensions of the 21-day period can occur in exceptional circumstance when the need for additional daily nursing care is finite and predictable.  (See, 42 U.S.C. § 1395x(m)(7)(B); Medicare Claims Processing Manual, Ch. 7 Section 40.1.3)

Additional Information

It is important for beneficiaries and advocates to know what home health care should be covered under the law, especially for those with long term, chronic, and debilitating conditions. Download our quick-reference Medicare Home Health Coverage Infographic, and, if you or someone you know has experienced home health care access issues, submit the story today.

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