Use of Utilization Screens and "Rules of Thumb"

20.3 - Use of Utilization Screens and "Rules of Thumb" (Rev. 1, 10-01-03) A3-3116.3, HHA-203.3 Medicare recognizes that determinations of whether home health services are reasonable and necessary must be based on an assessment of each beneficiary's individual care needs. Therefore, denial of services based on numerical utilization screens, diagnostic screens, diagnosis or specific treatment norms is not appropriate.