Home-Based Fall Evaluations and Interventions

Medicare covers home-based fall evaluations and interventions when there is a documented fall event and a comprehensive home-based evaluation that includes a detailed history and neurological/sensory, musculoskeletal, and vascular/cardiopulmonary reviews. Services provided by HHAs billed on 32x are paid under HH PPS, while services billed on 34x are treated as Part B outpatient rehabilitation and are subject to the CMS financial limitations (see Pub. 100-04, Ch.5 §10.2); documentation using the ICF framework and GBD approach is recommended to support coverage.

"Home-based fall evaluations and interventions are covered when there is a documented fall event(s) requiring a comprehensive, patient-centered evaluation in the home setting."

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