Frequently Asked Question of the Month: Can OT conduct the initial assessment and SOC Comprehensive Assessment when nursing is not involved in the case?
Yes, per the following: The Medicare Home Health Flexibility Act, effective January 1, 2022, does not alter Medicare’s criteria for establishing eligibility for the home health benefit as it relates to occupational therapy (OT). Medicare restricts occupational therapy as a qualifying service only when there is a “continuing need” of a previously certified home care patient.
The expanded OT role only applies to rehabilitation cases. Specifically, an occupational therapist may conduct the initial assessment and SOC Comprehensive Assessment if the physician’s referral order does not include skilled nursing care, but does include (1) occupational therapy, and (2) physical therapy or speech language pathology.
Symbria is committed to maintaining a high standard and level of communication with our clients and employees regarding clinical education, PDGM understanding, patient assessment, home health regulations, and coding efficiency. As a result, the Home Health Insider was born. In this monthly offering, we hope to provide some valuable information that can foster a quality level of care that meets the needs of the patients that we serve.