This is exciting news for our patients.
For Medicare part A Beneficiaries, Therapy services no longer need to be discontinued for “maintenance” or for a patient that is declining and not making functional progress.
Should the patient choose to continue their therapy services they are still entitled to receive therapy services even if they are not meeting their goals.
Note from Mike Auge, PT “With that, your mindset as clinicians needs to change and document why you are doing a maintenance plan and why therapy/skilled services are required. Ex: “No other capable individual is able to safely carry out a therapeutic exercise and perform gait/safety training.”
The three main requirements that must remain documented our homebound status, Explanation for skilled services, and what the goals are for a maintenance plan or to slow the progress of a progressive disease.
There was a recent lawsuit challenging Medicare to further define when therapy services are appropriate or required to discharge a patient that is no longer making progress functionally. The courts have ruled that therapy services do not have to discharge anymore if the patient is not making progress towards functional goals.