Home Health & Hospice

Weekly Q&A: Can the OT make his or her initial assessment visit before the PT does if all staff make their visits on the same day?

Homecare Insider, August 29, 2016

When you have a patient that is therapy only (PT and OT) and the RN performs a NBO visit to open the case and perform the comprehensive assessment and OASIS data collection, can the OT make his or her initial assessment visit before the PT does if all staff make their visits on the same day?

 

This is allowed, per Chapter 7, since eligibility has been confirmed. Now, if something happens and the qualifying service never had a chance to see the patient, there would be no payment. The following is from Chapter 7:
 

30.2.10 - Sequence of Qualifying Services and Other Medicare Covered Home Health Services (Rev. 1, 10-01-03)

A3-3117.2.J, HHA-204.2.J

Once patient eligibility has been confirmed and the plan of care contains physician orders for the qualifying service as well as other Medicare covered home health services, the qualifying service does not have to be rendered prior to the other Medicare covered home health services ordered in the plan of care. The sequence of visits performed by the disciplines must be dictated by the individual patient’s plan of care. For example, for an eligible patient in an initial 60-day episode that has both physical therapy and occupational therapy orders in the plan of care, the sequence of the delivery of the type of therapy is irrelevant as long as the need for the qualifying service is established prior to the delivery of other Medicare covered services and the qualifying discipline provides a billable visit prior to transfer or discharge in accordance with 42 CFR 409.43(f).


NOTE: Dependent services provided after the final qualifying skilled service are not covered under the home health benefit, except when the dependent service was followed by a qualifying skilled service as a result of the unexpected inpatient admission or death of the patient or due to some other unanticipated event.