There has been a longstanding myth that Medicare does not cover services to maintain or manage a beneficiary's current condition when no functional improvement is possible. The recent Jimmo vs. Sebelius final settlement sought to dispel this fallacy and provide clarifications to safeguard against unfair denials by Medicare contractors for skilled therapy services that aid in maintaining a patient's current condition or to prevent or slow decline. Review background on skilled maintenance coverage under Medicare.
This page contains helpful resources on the applicable Medicare regulations regarding skilled maintenance therapy as well as practice applications on how to properly treat patients when providing skilled maintenance therapy services.
Understanding What Defines "Skilled Maintenance"
Physical Therapist Practice in Skilled Maintenance
Legislative and Regulatory Activity