As those of you in home health know, Medicare has really changed the way they pay for therapy services.  How is your agency dealing with this change?  So far, I am seeing that 14  is the new 10.  (Those of you in home health will know what I mean).  This rather worries me, as a seminar I attended last June mentioned that 14+ visit episodes might be audit targets in the future.  What are other agencies doing?

My understanding is that 20 visits or more is a "red flag".  After a couple of months, I have been told many times to make sure a document functional progress on every visit whether it is with transfers, bed mobility, ADLs, or ambulation.  Most of agencies I work with are telling us to put what we think a patients needs, whether it is 6 visits, 13, or whatever.  As long as you can document progress, and as long as you justify every visit with functional progress beyond the 20, you will probably be ok.  I do work with a couple of agencies that are pushing for 14 visits, but quite frankly, I put what the patient needs.

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