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Does Medicare Cover Home Safety Assessments


Medicare does cover home safety assessments. The home safety assessment or evaluation must be ordered by the beneficiaries’ primary care physician. The home health care agency will bill Medicare, then your Part B benefits will pay for the assessment.

5 Medicare Home Safety Assessment Categories

The assessor will observe and discuss with you the following issues as they are relevant.

Five categories to assess during a home safety assessment:

  1. Fire Response (performed for all patients)
  2. Exit procedures – do you have a plan
  3. Smoke detectors – are they working.
  4. Fire extinguisher – do you have one
  5. Cause of fires and fire prevention – do you understand

Assessing the Structure of a Home

The intention is to confirm the floor is solid with no potential for holes causing persons to fall.

Structural limitations include:

  • Floor strength
  • Stairs
  • Adequate door width
  • Adequate ventilation
  • Equipment location acceptable
  • Home suitable for equipment/ service

Also, any stairs must be in good shape, and you must repair loose boards. The door width for an interior door is 36 inches standard.

But, both 30 and 32 inches are available. A wheelchair is 32 inches wide. A standard 36-inch-wide door is a preference.

Then, there would be no need to retrofit the existing door should a wheelchair be necessary.

Home Fall Risk Safety Assessment

While the statics show that 1 in 4 Americans over age 65 fall each year. Falling isn’t inevitable, and most falls can be prevented with a willingness to make a few changes.

Fall risk assessments include:

  • Throw rugs or runners
  • Loose carpeting
  • Extension cords in walkways
  • Uses O2 tubing over 25 feet
  • Clutter environment objects blocking the walkways
  • Pets in a home that could cause a fall

Consider removing and replacing any loose carpeting. Further, don’t use extension cords in the walkways. If you have throw rugs on the floor, consider double-sided tape or a non-slip backing to prevent falls.

Tape cords and wires next to a wall. As tempting as it might be to save old magazines or books, everything needs to be off the floor. Modifications can change your living environment and allow you to stay in your house.

You can add handrails, remove clutter, and add physical activity to your daily living.

Fire Hazard Assessment

The use of home oxygen is commonplace. But, most users may not be aware that oxygen under high pressure can be volatile.

Fire Hazards of oxygen can include:

  • Dangers of smoking– are there smoking materials in the home
  • Post a “no smoking” sign– due to the potential for open flames
  • Placement of oxygen– The patient or caregiver understand fire safety instructions.
  • Placement of back up oxygen

Home Electrical Safety Assessment

The assessor reviews these points when you obtain specific medical equipment. But, a home ventilator machine would require an assessment of the home’s electrical system.

Electrical factors include:

  • Sufficient electricity
  • Safe wiring
  • Outlets
  • Grounding
  • Power strips

FAQs

What is a home safety evaluation?
A home safety evaluation assesses the risks at your home. These risks could be from flood, fire, falls, or from potential intruders.
Does Medicare pay for falls?
Medicare will cover an injury from a fall or medication you need that results from a fall injury.
Does Medicare pay for fall risk assessment?
Medicare covers a fall risk assessment as part of your Welcome to Medicare visit.

How to Get Medicare Coverage for a Home Safety Assessment

You may be eligible for a home safety assessment if a doctor orders one due to a recent hospitalization. Also, those with home health care could be eligible for evaluation. Some non-profits provide home safety assessments for fall prevention.

The National Aging Council can help with eligibility for a home safety assessment. Then, a physical or occupational therapist can do the evaluation. The assessment falls under Part B; a Medigap plan can help cover the costs you'd otherwise pay.

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Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

13 thoughts on “Does Medicare Cover Home Safety Assessments

  1. Is a mobile outpatient therapist able to bill for this if a MD writes the order for “OT Eval and Treat.” this article makes it seem like it needs to be run through a home health agency, or be approved by a local Area Agency on Aging prior?

    1. Hi Dawn! This is a tricky one. The article points out that a home health agency must be Medicare-approved to do the home safety assessment. I would assume the same would apply with a mobile outpatient therapist. However, I would call Medicare directly to confirm.

    1. Hi Emily! I would contact Medicare directly to confirm, but I believe occupational therapists can bill Medicare for the home safety assessment. This PDF from CMS may provide additional insight as well.

    1. Hi Michael! Given you have to access the safety of the home, I don’t think it can be done virtually. However, I would contact the company that would be doing the assessment to see if they offer it via Telehealth.

    1. Toni, you are so very welcome! We don’t have them on hand to access, however, I did some research and I believe the PDF here may have them. The top of page two has CPT codes for both physical and occupational therapists to do home assessments. I hope this helps!

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