Home health services are medically necessary intermittent skilled services (skilled nursing, physical therapy, speech and language pathology and occupational therapy) and non-skilled services (home health aide services and medical supplies) provided to recipients who reside in private residences. Home health skilled services and medical supplies can be provided to recipients in an adult care home. Home health aide services cannot be provided in this setting because the personal care and incidental tasks are performed by the staff of the adult care home.
Refer to DMA’s website at http://www.dhhs.state.nc.us/dma/mp/mpindex.htm for specific coverage criteria, prior approval requirements, and service limitations.
Home health services include skilled nursing, home health aide services, physical therapy, speech and language pathology, occupational therapy, and medical supplies. Home health skilled services and aide services are provided on a per visit basis. Medical supplies may be provided to a recipient even when no home health services are needed.
Home health services are deemed appropriate when the recipient’s medical record accurately documents one or more of the reasons specified below relative to why the services should be provided in the recipient’s home instead of the physician’s office, clinic, or other outpatient setting.
REVISED 08/01/11 – CHANGE NO. 14-11
(XVIII. B. 2)
There are no copayments for home health services.
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.