What type of assistance is generally limited by Medicare coverage if provided without concurrent skilled services?
Answer
Aide services assisting with Activities of Daily Living (ADLs) like bathing and grooming.
Medicare’s primary focus in home health coverage is on medically necessary, intermittent skilled services that require clinical expertise. Non-skilled support, often termed custodial care or personal care provided by home health aides (such as assistance with bathing, grooming, feeding, or light housekeeping), is generally excluded from Medicare reimbursement unless these supportive tasks are delivered concurrently with ordered skilled care. If a patient's sole requirement is assistance with ADLs, they typically must rely on alternative funding sources like private pay or long-term care insurance policies for that specific aspect of support.
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