Medicare Benefit Policy Manual (Pub. 100-02), Ch. 7 § 20
Conditions To Be Met for Coverage of Home Health Services
20 - Conditions To Be Met for Coverage of Home Health Services
(Rev. 1, 10-01-03)
A3-3116, HHA-203
Medicare covers HHA services when the following criteria are met:
1. The person to whom the services are provided is an eligible Medicare beneficiary;
2. The HHA that is providing the services to the beneficiary has in effect a valid
agreement to participate in the Medicare program;
3. The beneficiary qualifies for coverage of home health services as described in
§30;
4. The services for which payment is claimed are covered as described in §§40 and
50;
5. Medicare is the appropriate payer; and
6. The services for which payment is claimed are not otherwise excluded from
payment.