Re: Homecare orders...

[Guest guest]

Concerning the question of how Medicare might view an order for a PT to

teach self care and bathing skills to a client in a home health setting:

Coverage issues:

A) Home health qualification: Is the patient homebound and a Medicare

beneficiary?

Skilled PT criteria:

1 Potential to make significant functional improvement?

2 Making progress toward predetermined functional goals every visit?

3 These specific teaching services require the specialized skills and

knowledge of the professional physical therapist?

4 Therapist and physician agree on a Plan of Care?

5 These specific services are recognized as specific to diagnosis?

6 Duration and frequency are reasonable and generally predictable?

CPT Code 97537:

" Self care/home management training (eg, activities of dailiy living

(ADL) and compensatory training, meal preparation, safety procedures,

and instructions in use of adaptive equipment) direct one on one contact

by provider, each 15 minutes. "

Regardless of whether the service is performed by the physician or a PT,

if the patient, the condition, and the care meet the above criteria and

are documented as such, Medicare would say it's exactly what they had in

mind.

Dick Hillyer, PT

Cape Coral, Florida