Ensuring Medically Necessary Physician or QHP Visits in Nursing Homes
In nursing home settings, ensuring medically necessary visits by physicians or Qualified Healthcare Professionals (QHPs) is critical for providing high-quality care and maintaining compliance with Medicare guidelines. This whitepaper outlines the definition of medical necessity, Medicare’s guidance on billing and documentation, and key considerations for determining the necessity of patient visits. Definition of Medical Necessity Medicare defines medical necessity as: “Services or items reasonable and necessary for the diagnosis or treatment of illness or injury…
