Medicare Qualifying Diagnosis
Is Inpatient Rehabilitation right for you? The following are requirements from CMS (Medicare) to qualify for Inpatient Rehabilitation. Your physician can help you by making a recommendation based on your condition.
Patient MUST have a qualifying diagnosis such as:
- Brain injury
- Spinal cord injury
- Major multiple trauma
- Neurological disorders (Parkinson’s disease, Guillain-Barre, etc.)
- Hip fracture (limited)
- Other debilitating conditions (limited)
Patient MUST have medical necessity requiring physician attention and rehab nursing during rehab stay such as, but not limited to:
- Cardiac, pulmonary or neurological medical needs
- HTN, anemia, dysphagia, oxygen desaturation, uncontrolled diabetes, etc.
- New diagnosis requiring teaching
Patient MUST be able to tolerate 3 hours of therapy daily for 5 of 7 days.
- Therapy is not done in 3 hour blocks, but done throughout the day
Benefits of Inpatient Rehabilitation
There are many benefits to inpatient rehabilitation, including:
- Inpatient Rehab builds strength, endurance, independence and confidence with a goal of returning patients to their prior level of function in the community.
- Administering intensive rehab helps patients return home and avoid extended stays in nursing homes.
- Inpatient Rehab builds confidence regarding safety at home and provides teaching regarding new diagnosis.