Medicare Benefit Policy Manual (Pub. 100-02), Ch. 7 § 50.7.2

Application of this Policy Revision

Last amended: 2003Year: 2003Length: 189 wordsOfficial source
50.7.2 - Application of this Policy Revision (Rev. 1, 10-01-03) A3-3119.7.D, HHA-206.7.D Additional care covered by other payers discussed in §50.7.1 does not affect Medicare coverage when the conditions listed below apply. A patient must meet the criteria for Medicare coverage of home health services, before this policy revision becomes applicable to skilled nursing services and/or home health aide services. The definition of "intermittent" with respect to the need for skilled nursing care where the patient qualifies for coverage based on the need for "skilled nursing care on an intermittent basis" remains unchanged. Specifically: 1. This policy revision always applies to home health aide services when the patient qualifies for coverage; 2. This policy revision applies to skilled nursing care only when the patient needs physical therapy or speech-language pathology services or continued occupational therapy, and also needs skilled nursing care; and 3. If the patient needs skilled nursing care but does not need physical therapy or speech-language pathology services or occupational therapy, the patient must still meet the longstanding and unchanged definition of "intermittent" skilled nursing care in order to qualify for coverage of any home health services.
Medicare Benefit Policy Manual (Pub. 100-02), Ch. 7 § 50.7.2: Application of this Policy Revision | Justis AI