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Home Health Occupational Therapy

Medicare Benefit Policy Manual (CMS Pub. 100-02, Ch. 7 §40.2.4)External PDF

Visits by an occupational therapist to assess and reassess a beneficiary's rehabilitation needs and potential, or to develop and/or implement an occupational therapy program, are covered when reasonable and necessary because of the beneficiary's condition.

It should be clear in the documentation that the occupational therapist is working on functional limitations and tasks with the beneficiary.

New requirements were mandated in the Calendar Year 2013 Final RuleExternal PDFfor therapy services provided in the home health setting for episodes beginning on or after January 1, 2013. In addition, the Centers for Medicare & Medicaid Services (CMS) published FAQsExternal PDFon this topic.

Updated: 06.26.13

Reviewed: 12.10.21

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