Healthcare Provider Solutions

Since 2011, home care agencies have suffered under the administrative burden of stringent therapy reassessment requirements that required a therapy reassessment visit for each discipline of therapy at least once every thirty days as well as a reassessment by each discipline of therapy on exactly the 13 th and 19th visit in a single discipline therapy case and during a range of visits approaching these thresholds in multi discipline cases. This burden has been an administrative headache for all providers and resulted in lost revenue when these requirements were not met. The 2015 Home Care Final rule has relaxed the therapy reassessment requirements considerably, eliminating the additional reassessment required at the 13th and 19th visit threshold and requiring only a functional reassessment by each discipline of therapy at least once every thirty days.

The requirements for what meets the standard of a functional reassessment have not changed.

See excerpt from 2015 final rule:

 Therapy reassessments are to be performed using a method that would include objective measurement, in accordance with accepted professional standards of clinical practice, which enables comparison of successive measurements to determine the effectiveness of therapy goals. Such objective measurements would be made by the qualified therapist using measurements which assess activities of daily living that may include but are not limited to eating, swallowing, bathing, dressing, toileting, walking, climbing stairs, or using assistive devices, and mental and cognitive factors. The measurement results and corresponding effectiveness of the therapy, or lack thereof, must be documented in the clinical record.

As originally published, there was an error in the final rule related to the therapy reassessment requirement. Originally the final rule applied these new requirements to episodes ENDING in 2015. This was a mistake in the final rule. These new requirements apply to episodes BEGINNING in 2015.

Links to the final rule as well as the correction notice are provided below:

Final Rule

Correction Notice