Idaho Medicaid Provider Handbook, Home Health and Hospice Services § 3.4

Home health services include skilled nursing and at least one of the following services provided

where the participant’s normal life activities take place.

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Home Health Aide Services

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Medical Social Services

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Occupational Therapy

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Physical Therapy

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Speech-Language Pathology

Home health services also include audiology, and Durable Medical Equipment and Supplies.

Services provided must follow the requirements of the service’s chapter of the provider

handbook. Where home health and the service’s requirements conflict, the more restrictive

requirement prevails.

All home health services must be medically necessary and on the Orders of a physician, nurse

practitioner, clinical nurse specialist or physician assistant as part of a home health Plan of

Care. Medicaid requires all Medicare conditions of eligibility including, but not limited to, the

Outcome and Assessment Information Set (OASIS) documentation be followed.

Services are typically provided in the participant’s residence but can be provided anywhere

normal life activities take place. Services are prohibited from being provided in a hospital,

nursing facility, intermediate care facility for individuals with intellectual disabilities (ICF/IID)

(unless the ICF/IID is not required to provide that service), or any other place with inpatient

services including room and board.

Home health services are limited to a total of 100 medically necessary visits per calendar

year. A visit consists of all services that occur on a date of service. The delivery of durable

medical equipment and supplies alone does not constitute a visit. Additional visits require

prior authorization from the Medical Care Unit. See the Home Health: Prior Authorization

section for more information.