Home Health Reimbursement

  1. Can anyone tell me the reimbursement for home health visits?

    RN's vs LPN's vs CNA's

    Also, if your patient requires daily nursing visits, say with wound care or IV's, do you get reimbursed per visit. What about twice a day visits? Are they both reimbursed?

    THanks for all that help out with answers to my questions. We are looking to open up a specialty home health service dealing with wound care, iv therapy, and so forth.......

    This will answer the biggest question.
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  2. Visit bobnurse profile page

    About bobnurse

    Joined: Sep '04; Posts: 476; Likes: 32

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  3. by   Traveler
    I have been in hh for 4 years. There is more paperwork in hh than in any other area of nursing. Most patients will be Medicare. When Medicare started with PPS, patients are certified for a period of 60 days. Basically this is how it works. Upon admission an OASIS is done by the RN. From the OASIS, certain items are worth "points". (Dyspnea, pressure ulcers, IV's, tubes, functional status, need for therapy, etc.) Based upon the points in each area, they fall into a category. Based upon your geographic location and if you are rural or urban, there is a fixed reimb. rate for the entire 60 day period. It is very very rare that we do daily wound care. Our IV's are usually with Medicaid or private insurance. They prefer for us to teach the family in around 3 visits how to do IV's. In order to operate an agency, you have to apply for a Certificate of Need in your area. All of the OASIS data is transmitted electronically to the govt. Since PPS, many HH agencies have closed their doors. We went from being able to send a HHA 3/day to max 3/week. With Medicare (Medicaid and private ins. tend to be mroe strict), there has to be a skill- this can be teaching or a procedure. However, VP no longer count as a skill. We used to have lots of hh patients who had monthly PT/INR- we still do that, but it is not a certifying reason. For injections (b12, etc.) we have to document about why patient or c/g can't do it or be taught to do it. There is much to know in hh and appropriate coding is a must. PM me if you have any more questions.

    Ann

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