What type of care must a physician certify for home health care reimbursement?

To qualify for home health care reimbursement, a physician must certify that the patient requires skilled nursing care on an intermittent basis. This certification is critical because home health services, as defined by Medicare and other insurers, are intended for patients who need medical care that cannot be satisfactorily provided solely through unskilled support.

Skilled nursing services include treatments that must be performed by trained personnel, such as administering medications, performing wound care, or monitoring a patient's health status. The "intermittent basis" requirement indicates that the skilled care does not need to be provided continuously but rather periodically, as needed, reflecting the nature of home health services, which are intended to assist patients while allowing them to maintain a level of independence.

This type of care contrasts with other forms that might require continuous supervision or specialized facilities, such as long-term hospital care, emergency nursing care, or mandatory outpatient services, none of which align with the criteria that must be met for home health care reimbursement. Thus, the certification of need specifically for skilled nursing on an intermittent basis forms the foundation for these reimbursement processes.