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Home Health Supplies

Medicare Benefit Policy Manual (Pub. 100-02, Ch. 7, § 50.4)External PDF

Medical supplies are items that, due to their therapeutic or diagnostic characteristics, are essential in enabling home health agency personnel to conduct home visits or to carry out effectively the care the physician has ordered for the treatment or diagnosis of the patient's illness or injury.

Supplies fit into two categories. They are classified as:

  1. Routine supplies - because they are used in small quantities for patients during the usual course of most home visits; or
  2. Nonroutine supplies (NRS) - because they are needed to treat a patient's specific illness or injury in accordance with the physician's plan of care and meet further conditions discussed in more detail below.

Non-routine supplies are adjusted separately based on six severity groups and are added into the HHA's total episode payment. No supply payments are made for home health claims paid as Low Utilization Payment Adjustments (LUPAs).

Per the Medicare Benefit Policy Manual (Pub. 100-02, Ch. 7, §, medical supplies including catheters, catheter supplies, ostomy bags and supplies related to ostomy care furnished by an HHA are specifically excluded from the term "orthotics and prosthetics". These items are bundled while a patient is under a home health plan of care, and an HHA must furnish them to the patient, even if the HHA is not treating a condition/illness requiring these supplies.

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Updated: 12.22.15

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