Home Health Services

Home Health Services include medically necessary skilled nursing services, specialized therapies (such as physical therapy, speech-language pathology and occupational therapy), home health aide services and medical supplies. These services are provided to beneficiaries in any setting where normal life activities take place, excluding hospitals, nursing facilities or intermediate care facilities for individuals with intellectual disabilities.  

Home health services may be provided in an intermediate care facility for individuals with intellectual disabilities, but only if these services are not required to be provided by the facility under subpart I of part 483. Additionally, services cannot be provided in any setting where payment is or could be made under Medicaid for inpatient services, which include room and board. Home health services cannot be limited to services furnished to beneficiaries who are homebound in accordance with 42 CFR 440.70.

Medically necessary services include:

• Home health aide services
• Skilled nursing services
• Medical supplies
• Specialized therapies, including:
  • physical therapy
  • speech-language pathology
  • occupational therapy
• Skilled nursing, specialized therapies and medical supplies can be provided if the beneficiary resides in an adult care home (such as a rest home or family care home).

Additional Information

• Home Health Services Electronic Visit Verification Implementation  -  April 12, 2022
• Fee Schedules
• Clinical Coverage Policy 3A, Home Health Services

Forms

• Home Health Services Forms

Contact

NC Medicaid Clinical Section
Phone: 919-855-4380
E-mail: Medicaid.HomeCareService@dhhs.nc.gov