Frequently Asked Question of the Month:
How are supplies and equipment reimbursed under a home health episode?
Generally, any equipment/supplies needed would be the responsibility of either the HHA or the patient; the contract therapy company would not be responsible for these items.
Per Chapter 7 of the Medicare Benefit Policy Manual:
50.4.1 – Medical Supplies (Rev. 10438, Issued: 11-06-20, Effective: 03-01-20, Implementation: 01-11-21)
Medical supplies are items that, due to their therapeutic or diagnostic characteristics, are essential in enabling HHA 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. All supplies which would have been covered under the cost-based reimbursement system are bundled under home health PPS. Payment for the cost of supplies has been incorporated into the per visit and 30-day period payment rates. Supplies fit into two categories. They are classified as:
- Routine – because they are used in small quantities for patients during the usual course of most home visits.
- Non-routine – because they are needed to treat a patient’s specific illness or injury in accordance with the physician or allowed practitioner’s plan of care and meet further conditions; all HHAs are expected to separately identify in their records the cost of medical and surgical supplies that are not routinely furnished in conjunction with patient care visits and the use of which are directly identifiable to an individual patient.
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.