The Jimmo vs. Sebelius settlement clarified that coverage of skilled therapy services in the skilled nursing facility, home health, and outpatient therapy settings does not turn on the presence or absence of improvement, but rather on the need for skilled care. This settlement opened the door to support reimbursement of skilled occupational therapy services to maintain a client’s current condition or prevent or slow deterioration of their condition. Many occupational therapy practitioners, however, are unsure of how to apply the Center for Medicare & Medicaid Services' clarification to effectively deliver and document skilled maintenance therapy plans of care that support reimbursement.
- Distinguish between rehabilitation, maintenance therapy, and non-skilled maintenance programs
- Identify key criteria for skilled maintenance therapy provision
- Effectively document maintenance therapy treatment to support reimbursement
Constance Sakellaropoulos, MOTR/L; Kim Karr, OTR/L, RAC-CT, CPHQ and Julie Lenhardt
Earn 1.5 Contact Hour
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