Physical Therapy - Home Health

Home health physical therapy is covered when physician-referred, reasonable and necessary, and requires the skills of a licensed physical therapist or LPTA with a physician-certified plan specifying measurable goals, frequency, duration, and objective documentation of functional limitation. Vestibular rehabilitation (H81.*) is covered for documented vestibular hypofunction or BPPV with appropriate testing; maintenance programs and select device instruction (e.g., TENS) have specific limits and documentation requirements. Numerous services and modalities (including many investigational therapies, routine nursing care, group therapy in home, and certain wound or pelvic-floor modalities) are explicitly non-covered or limited without documented medical necessity.

"Patient must be under the care of and referred for physical therapy services by a physician (MD, DO, or podiatric physician when within state scope)."