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Ep 63: Home Health OT vs OT in the Home: Differences in Billing and Practice
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Home Health OT vs OT in the Home: Differences in Billing and Practice
Welcome to The Amplify OT Podcast with your host, Clarice Grote—occupational therapist, founder of Amplify OT, and self-proclaimed policy nerd who actually enjoys reading the long documents most people avoid.
No matter where you are in your occupational therapy journey, you belong here as an important part of this community. The work you do matters. Your voice matters. And advocacy isn’t just possible—it’s powerful.
Let’s get started—because change starts here.
View all Amplify OT Podcast episodes at podcast.amplifyot.com
Find where to listen to the Amplify OT Podcast at podcast.amplifyot.com/listen
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🚨 Overwhelmed by OT policy, billing, and Medicare rules?
You’re not alone—and that’s why the Amplify OT Learning Platform exists. Designed by an OT for OTs and OTAs, this on-demand resource hub helps you finally understand the “why” behind the rules so you can advocate confidently, bill accurately, and stop second-guessing your documentation.
✨ What you get:
✔ Self-paced courses on Medicare, billing, and advocacy
✔ Real-world examples and easy-to-digest lessons
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✔ Support from a community that gets it
Ready to take the guesswork out of OT policy? Join today and amplify your knowledge, your confidence, and your impact.
👉 Click here to learn more and get started!
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Providing OT in the home or doing mobile outpatient has become so much more popular in the last few years, especially for individuals who are branching out into their own private practices. But if you’re working for one of these companies or considering starting your own, it’s important to understand the differences in billing and scope of practice between the two, as it greatly impacts patient care and reimbursement. That’s why this week on The Amplify OT Podcast, I am talking about home health OT vs OT in the home: key differences in billing and practice!
In this episode, I cover:
- The fundamental differences between home health (Medicare Part A, provided by home health agencies) and OT in the home (mobile outpatient, typically billed under Medicare Part B).
- Key eligibility and admission criteria for each setting, including what “homebound status” really means.
- How billing and reimbursement work, from value-based and bundled payments (PDGM for home health) to fee-for-service, timed codes, and considerations for cash-pay.
- The critical role of “qualifying services,” why OT isn’t currently considered qualifying under Medicare Part A, and important advocacy efforts to change this.
- Scope of OT practice in each setting—why home modifications and specialized services are more prevalent in mobile outpatient, and why home health tends to be more generalist due to payment structure.
Amplify OT Resources
Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com to check ‘em out!
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Looking for CEUs? Save with MedBridge!
Whether you’re a student or practicing clinician, MedBridge has a CEU plan for you—with hundreds of evidence-based courses, clinical resources, and tools to support your OT practice.
Amplify OT listeners can save:
- $101 off individual plans with code AmplifyOT → View Plans
- Up to $75 off student plans with code AmplifyOTStudent → Student Plans
- Home Health & Hospice CEUs → Home Health Resources
- Compliance & Annual Training → Compliance Training
- Explore solutions for groups and employers → Group Plans
Affiliate disclaimer: These are affiliate links, which means Amplify OT may earn a commission at no extra cost to you. Your support helps us continue to offer free resources and education for the OT community.
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LINKS MENTIONED IN THIS EPISODE:
- Ep 11: Q&A: Is OT a Qualifying Discipline in Home Health
- Ep 9: Patient-Driven Groupings Model (PDGM) in Home Health
- Contact your legislator and ask them to pass the home health accessibility bill @ aota.org/takeaction
- Home Health Resources [Amplify OT]
- Can Occupational Therapists Opt Out of Medicare? [Amplify OT]
CONNECT WITH AMPLIFY OT:
© Amplify OT® and Clarice Grote
Mentioned in this episode:
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