Wiki Home Care MSW

What types of plans Is Medical Social Work a billable service for under Home Care

Home health care is a payment model where all services are provided by the Home Health agency, and paid under a single consolidated payment that covers everything rendered to the patient. Generally, you cannot bill separately for services exclusively covered under the care plan and reimbursed in full to the agency. If the care plan requires psychotherapy to be rendered by a MSW and the HH Agency doesn't have a social worker, then there would need to be a payment arrangement with the agency to the social worker to provide a certified service that they cannot render (sometimes this happens with wound care). If the HH plan of care doesn't include psychotherapy, then the social worker could see the patient independently, but Medicare won't pay for it unless it's deemed medically necessary, and the therapist would have to go to the patient's home as they are homebound.

This is Medicare (usually the standard by which all other payers follow). If home health care is covered by a commercial payer, you will need to review the payment policies in order to find out what they cover, how they pay, and if MSW services are bundled into the HH services. It may be the same, but you'll have to do your due diligence. It's not as simple as billing an insurance company for a patient that's certified under a HH Plan of care and expecting to get paid, because you probably won't.