When Medicare Will Pay for Skilled Nursing or Physical Therapy - Howard Gleckman:
http://howardgleckman.com/author/hgleckman/
Two weeks ago, the government updated the Medicare manual—the
official guidelines for providers. And it has begun an extensive
educational campaign to help them understand the rules. Yet, it is
important that consumers know about this new interpretation as well.
What does this mean? Imagine you have a severe stroke. Before Jimmo,
most people thought Medicare would pay for physical therapy only as
long as that PT was helping you get better. For instance, Medicare would
pay if therapy helped increase the number of steps you could walk
without assistance. Now, Medicare will pay for PT even if it only helps
you maintain your current ability to walk
other restrictions still apply. For instance, Medicare will only pay for skilled nursing care after a patient has been hospitalized for at least three days. And, at least for now, a patient who is in a hospital for observation but has not been formally admitted does not qualify. Medicare will pay for no more than 100 days of skilled care after a hospitalization. And Medicare will not pay for skilled care if needed services can be provided by the patient herself, her family, or by home health aides.
