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Outpatient Therapy Services by Home Health Care Agency

Outpatient Therapy Billing

Can home health care agencies bill Medicare Part B for outpatient services? 


Yes. According to CMS, outpatient therapy services may be provided by a home health agency to patients who are not homebound or otherwise are not receiving services under a home health plan of care (POC). These services are not paid under the Home Health Prospective Payment System (HH PPS). The reimbursement for the outpatient therapy services is calculated using the Medicare Physician’s Fee Schedule (MPFS).

Many Medicare certified home healthcare agencies are finding outpatient therapy at home to be a viable option for their business. This model provides a win-win situation for both the patient and the agency.  When a home health patient improves and is no longer homebound, but still in need of therapy services, agency may discharge the patient from home health care and admit the patient to their outpatient therapy services. 

This model brings great benefits to the patient:


This model provides great benefit for the agency:


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Billing for Outpatient Therapy Services

While your agency bills Medicare Part A for your home health care services, outpatient therapy services need to be billed under Medicare Part B. Having a home health software for billing Medicare Part B for outpatient therapy services will help agencies manage both business lines using one system. Alora is capable of billing Medicare Part B for home health care agency.

A Word of Caution

Even though there are several benefits for Medicare certified home health agencies to provide outpatient therapy services, there are many compliance and documentation requirements that the agency needs to pay close attention to.  If your agency is considering the idea of starting outpatient therapy business, be sure to take time thoroughly review all of the Medicare requirements or get professional help from experienced consultants.

For more information on outpatient therapy services billing requirements in your state, general homecare news, or on Home Health Software technology, email us at

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