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Hi ,

Medicare Benefits Policy Manual language allows treatment for outpatient PT

(Part B) to be done in the patients home so yes it is legal. Most other

insurances do as well but you would need to check with private insurance

policy. It is not home health (covered under Medicare Part A) most commonly

because the person is no longer homebound per Medicare regulation.

Our clinic has used this successfully to treat if there is a good reason

that coming to the clinic is difficult, for instance, in the winter when bad

weather would make an otherwise independent person a fall risk. WE have

also done it with people post MVA who are in too much pain to sit in a car

and come to the clinic.

Most clinics will do it sparingly because travel time is not reimbursed so

time management and productivity become difficult.

Billing is done just like for treatment in the clinic.

While not in the Medicare regulations, I always recommend documenting the

reason that you are seeing a person at home instead of the clinic.

Tom

thowell@...

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From: PTManager [mailto:PTManager ] On Behalf

Of jmelipt@...

Sent: Thursday, July 07, 2011 7:03 AM

To: PTManager

Subject: Homecare

I notice some private practices are starting to provide services at home.

How is this different from homecare? Is this legal? They bill units just as

if they were in an office. My understading is that medicare homecare is a

different fee schedule vs. billable units for outpatient.

Meli, PT

Bayside, NY

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Guest guest

One thing I will add to Toms response is the place of service code changes from

an 11 to a 12 if seeing the patient in their home and billing on a 1500 claim

form.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

http://www.gawendaseminars.com

On Jul 7, 2011, at 3:52 PM, " M. Howell PT, MPT "

wrote:

> Hi ,

>

> Medicare Benefits Policy Manual language allows treatment for outpatient PT

> (Part B) to be done in the patients home so yes it is legal. Most other

> insurances do as well but you would need to check with private insurance

> policy. It is not home health (covered under Medicare Part A) most commonly

> because the person is no longer homebound per Medicare regulation.

>

> Our clinic has used this successfully to treat if there is a good reason

> that coming to the clinic is difficult, for instance, in the winter when bad

> weather would make an otherwise independent person a fall risk. WE have

> also done it with people post MVA who are in too much pain to sit in a car

> and come to the clinic.

>

> Most clinics will do it sparingly because travel time is not reimbursed so

> time management and productivity become difficult.

>

> Billing is done just like for treatment in the clinic.

>

> While not in the Medicare regulations, I always recommend documenting the

> reason that you are seeing a person at home instead of the clinic.

>

> Tom

>

> thowell@...

>

> This email and any files transmitted with it may contain PRIVILEGED or

> CONFIDENTIAL information and may be read or used only by the intended

> recipient. If you are not the intended recipient of the email or any of its

> attachments, please be advised that you have received this email in error

> and that any use, dissemination, distribution, forwarding, printing or

> copying of this email or any attached files is strictly prohibited. If you

> have received this email in error, please immediately purge it and all

> attachments and notify the sender by reply email.

>

> From: PTManager [mailto:PTManager ] On Behalf

> Of jmelipt@...

> Sent: Thursday, July 07, 2011 7:03 AM

> To: PTManager

> Subject: Homecare

>

> I notice some private practices are starting to provide services at home.

> How is this different from homecare? Is this legal? They bill units just as

> if they were in an office. My understading is that medicare homecare is a

> different fee schedule vs. billable units for outpatient.

>

> Meli, PT

> Bayside, NY

>

>

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