Page 101 - CHHA Binder 2.3.20

4/11/2019

Medicare Pros & Cons

Pros Cons

 Payor of choice, especially  Covers only skilled needs
for home rehab
 Patient must be
 Many initiatives in place to try homebound
to obtain Medicare cases
 Allows for agency to manage  Face to Face Encounter
services Form (FFE) is needed
 Pays on time  MD enrolled in PECOS

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Reimbursement

Medicare: federally funded program that provides health care services for
those over 65, and those under 65 with chronic disability or ESRD/Dialysis

 Part A
o Hospital
o Home Care
o Hospice
o Skilled Nursing Facility (sub acute)
o Most Supplies

 Part B
o Physician appointment
o Outpatient Treatment
o Home Care if no Part A
o DME

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