Medicare Benefit Policy Manual (Pub. 100-02), Ch. 12 § 40.10

Home Environment Evaluation

Last amended: 2009Year: 2009Length: 258 wordsOfficial source
40.10 - Home Environment Evaluation (Rev. 111, Issued: 09-25-09; Effective Date: 07-07-08; Implementation Date: 10-26- 09) One single, home environment evaluation visit is a covered CORF service if it is included in the physical therapy, occupational therapy or speech-language pathology plan of treatment. The single home environment evaluation visit allows the evaluation of the patient in the home environment and the assessment of the potential impact on the patient’s rehabilitation goals. The purpose of the home environment evaluation is to permit the rehabilitation plan of treatment to be tailored to take into account the patient’s home environment. However, Medicare does not pay for physical alterations to the home that facilitates the patient’s rehabilitation. The patient must be present during the home environment evaluation visit, which must be performed by the physical therapist, occupational therapist or speech-language pathologist, as appropriate. The patient’s presence is necessary to fully evaluate the potential impact of the home situation on the rehabilitation goals as specified in the plan of treatment. The home environment evaluation visit is not covered as a routine service for all CORF patients. It is covered only if, in establishing or carrying out the physical therapy, occupational therapy, or speech-language pathology plan of treatment, there is a clear indication that the home environment might adversely affect the patient’s rehabilitation. Coverage is limited to the services of one professional, either a physical therapist, occupational therapist, or a speech-language pathologist who provides the therapy services established in the corresponding plan of treatment that identifies the necessity for the home environment evaluation visit.
Medicare Benefit Policy Manual (Pub. 100-02), Ch. 12 § 40.10: Home Environment Evaluation | Justis AI