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The Home Health Services (HHS) program provides in-home medical services to Iowans by Medicare-certified home health agencies.
Back to topEligibility
- A member does not have to be determined homebound in order to receive home health services.
- A physician must certify that a member has a medical need for home health services through a face-to-face encounter.
- The physician must review and sign the HHS plan of care (POC) every 60 days. The physician’s signature on the plan of care authorizes the service(s) as an assessed medical need(s).
Care Services & Limits
HHS does not include medical needs that can be met by a family member, significant other, friend, neighbor, community or other unpaid resources.
The per visit rate is a fee schedule that is based on the low utilization payment adjustment (LUPA) methodology. The medical services included in the HHS program and corresponding limits are as follows:
| Home health services | Limits |
|---|---|
| Skilled nursing | 5 visits maximum per week |
| Wound therapy or insulin injection | Maximum visits based on medical need |
| Home health aide | 28 hour maximum, converted to visit , per week |
| Physical therapy | Visits per week based on medical need |
| Speech language therapy | Visits per week based on medical need |
| Occupational therapy | Visits per week based on medical need |
Regulation of Care
To prevent duplication of same or similar services and to ensure that the member’s comprehensive needs are met, the HHS POC must include all services, regardless of funding source, and unpaid supports provided to the member.
These goals require that the HHS provider coordinate and communicate with caregivers, legal representatives or unpaid sources, providers of other services; and/or a DHS service worker or case manager, who may be assigned to a member. HHS providers are reimbursed per visit.