Summary

In this office hours episode, Sue Doyle, PhD, OTR/L, unpacks how Medicare and reimbursement really work when you’re providing home safety and home modification services. She explains what counts as medical necessity, when you can and cannot bill, and how to protect both your clients and your practice while still offering valuable cash-based options.

Questions answered in this episode:

When is a home safety or home modification assessment considered medically necessary and covered, and when is it purely aging-in-place or preventative and not covered?

How do Medicare rules like mandatory claim submission, fall-risk guidelines, and quality measures (such as MIPS 154 and 155) affect what you can bill for and how you document your services?

What do therapists need to know to ethically offer cash-based home mods, set clear policies, and distinguish covered from non-covered services in day-to-day practice?

Mentioned resources and links:

• Certified Home Accessibility Therapist (CHAT): https://www.thehomeaccessibilitytherapist.com/CHAT
• Courses & Memberships: https://www.thehomeaccessibilitytherapist.com/courses
• Any handouts, checklists, or blog posts referenced:

Submit a question for a future episode:

• Use the question form here: https://www.thehomeaccessibilitytherapist.com/SubmitQuestion
• Or email your question to: sue@thehomeaccessibilitytherapist.com

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