CMS Pub. 100-02, ch. 12, § 40.10

One single, home environment evaluation visit is a covered CORF service if it is included

in the physical therapy, occupational therapy or speech-language pathology plan of

treatment. The single home environment evaluation visit allows the evaluation of the

patient in the home environment and the assessment of the potential impact on the

patient’s rehabilitation goals. The purpose of the home environment evaluation is to

permit the rehabilitation plan of treatment to be tailored to take into account the patient’s

home environment. However, Medicare does not pay for physical alterations to the home

that facilitates the patient’s rehabilitation. The patient must be present during the home

environment evaluation visit, which must be performed by the physical therapist,

occupational therapist or speech-language pathologist, as appropriate. The patient’s

presence is necessary to fully evaluate the potential impact of the home situation on the

rehabilitation goals as specified in the plan of treatment.

The home environment evaluation visit is not covered as a routine service for all CORF

patients. It is covered only if, in establishing or carrying out the physical therapy,

occupational therapy, or speech-language pathology plan of treatment, there is a clear

indication that the home environment might adversely affect the patient’s rehabilitation.

Coverage is limited to the services of one professional, either a physical therapist,

occupational therapist, or a speech-language pathologist who provides the therapy

services established in the corresponding plan of treatment that identifies the necessity for

the home environment evaluation visit.