Frequently Asked Question of the Month:
True or False? Home Health therapy visits must be 37 minutes, 48 minutes, or some other exact length of time, at a minimum.
False. This myth was generated from the research to develop the Home Health PPS system. However, Medicare never formally defined the amount of time required to ‘claim’ a visit. A “visit” begins with the delivery of covered home health services and ends at the conclusion of delivery of home health services. Neither the Medicare Benefit Policy Manual, nor the Medicare Claims Processing Manual defines a minimum time increment that constitutes a therapy visit. The length of the session should be based on the clinical presentation of the patient and the judgment of the therapist. Your software may have edits that require a minimum number of minutes to finish and count a visit; but that is not a CMS requirement. *Note: It is advisable to check with other payers to determine if they have a minimum required time increment that constitutes a therapy visit. Therapy contractors should inquire if the HHA has a policy about a minimum required time increment.
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.