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Home Health Medical Social Worker
Home health services provided by Medical Social Workers (MSWs) are covered by Medicare as a dependent service, meaning there must first be a “qualifying skilled service” in the home, such as intermittent skilled nursing services, physical therapy, speech-language pathology, or continuing occupational therapy services. If the qualifications are met, and the beneficiary faces a roadblock to recovery that requires the skills of an MSW to remove, MSW services would be covered.
Covered medical social services include:
- Assessing social and emotional factors related to the beneficiary's illness, care needs, response to treatment, and adjustment to care.
- Assessing the relationship between medical/nursing requirements, home situation, financial resources, and available community resources.
- Providing short-term services (two to three visits) to a beneficiary's family member or caregiver when a brief intervention is necessary to remove a clear impediment to effective treatment or recovery.
- Taking appropriate action to obtain available community resources to resolve the beneficiary's problem.
Services not covered under Medicare’s home health benefit include:
- Services aimed at minimizing illness-related problems for the beneficiary and family members.
- Preventive counseling, such as financial planning.
- Visits solely to assist in filling out routine forms.
- Follow-up visits that do not require a home visit.
- Routine evaluations at the start of care where no problems are documented.
- Orders for assessment of social/emotional factors, financial assessment, long-term planning, and counsel without identifying a specific reason or problem.
- Services that can be handled by a lay person or other disciplines.
- Problems related to normal stress situations and adjustment periods required by any type of illness.
Don’t hesitate to reach out to us for any further information. We’re just a click away, ready to answer your queries and assist you on your health journey.