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Medicare's Requirements for Inpatient Skilled Rehabilitation

Posted by Ruby Cemental on Sep 12, 2017 5:30:00 PM

Rehab_seniors-LR.jpgInpatient skilled rehabilitation is often required for seniors recovering from surgery, injury, or illness. When a patient needs continued multiple therapies to recover, he or she will be transferred or admitted into an IRF, or Inpatient Rehab Facility.

In order for medicare to cover this therapeutic approach to recovery, the patient must meet the following requirements.

Require Multiple Therapy Disciplines

In order to qualify for coverage, the patient must require at least two forms of therapy. One of the two must be physical therapy or occupational therapy. The second may be any of the following disciplines:

  • physical therapy
  • occupational therapy
  • speech-language pathology
  • prosthetic/orthotics

Require an "Intensive Rehabilitation Therapy Program"

This is the minimum therapy time requirement required in order for IRF to be covered by medicare. The patient's doctor will be required to document and support that the patient meets at least one of the following requirements:

  • 3 hours of therapy per day for at least 5 days per week, which must begin within 36 hours of admission.
  • At least 15 hours of therapy within 7 consecutive days, which must begin with the date of admission.

Reasonably Be Expected to Benefit From IRF

The physician must expect, within reason, that the patient will benefit from an intensive multiple disciplinary approach to therapy.

Require Supervision by a Physician Specializing in Rehabilitation

A rehabilitation physician is required to visit the patient 3 days per week. The physician must assess the patient's progress and make necessary adjustments to the patients therapy as needed.

Require a Team Approach Consisting of Multiple Therapy Disciplines

A patient requiring multiple forms of therapy will respond best to treatment when all of the therapists work together. This prevents one form of therapy from interfering with another.

Admission to an IRF can help a senior recover more quickly and fully from injury or illness. It is a step to getting the patient back into their normal routine more quickly and safely.

At Caring Senior Service, our expert staff is comprised of extremely knowledgeable, friendly, and trusted professionals who take pride in helping your loved one manage their daily activities. Contact us today to learn more!

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Topics: Medicare