Question
Does Medicare pay for OT treatment for cognitive dysfunction?
Answer
How do you set up your goals and are you making measurable progress towards your goals? I think sometimes it is looking at how do you develop your treatment and plan. Are you shooting for the moon with your long and short-term goals, or can you make your short-term goals and long-term goals more incremental? If you are showing progress and meeting your goals, you can justify the need for continued treatment within your documentation. There is not a set time frame.
Of course, we do have to work within the Medicare or private insurance company's guidelines. This might be somewhat dependent on your Medicare intermediary. Overall, if you can show progress within your short-term goals and show that you are meeting those benchmarks, then you are going to have more success with reimbursement.
Yes, the laws are constantly changing. We need to search our own CMS guidelines and be able to access that information on the web. We also need to be able to advocate for clients with our Medicare intermediaries. These are scalable, billable interventions. Again, as clinicians, we need to set up our treatment plans to document success and progress.
