Per-visit limits on home health services reimbursement.
(a)#
In this subsection: 2. “Licensed practical nurse” has the meaning given in s. 146.40 (1) (c). 2m. “Nurse aide” has the meaning given in s. 146.40 (1) (d). 3. “Occupational therapist” has the meaning given in s. 448.96 (4). 4. “Patient care visit” means a personal contact with a patient that is made by a registered nurse, licensed practical nurse, nurse aide, physical therapist, occupational therapist, or speech-language pathologist who is on the staff of or under contract or arrangement with a home health agency, or by a registered nurse or licensed practical nurse practicing independently, to provide a service that is covered under s. 49.46, 49.47, or 49.471. “Patient care visit” does not include time spent by a nurse, therapist, or nurse aide on case management, care coordination, travel, record keeping, or supervision that is related to the patient care visit. 5. “Physical therapist” has the meaning given in s. 448.50 (3). 6. “Registered nurse” has the meaning given in s. 146.40 (1) (f). 7. “Speech-language pathologist” means an individual engaged in the practice of speech-language pathology, as regulated under ch. 459.
(a)(2)#
“Licensed practical nurse” has the meaning given in s. 146.40 (1) (c).
(a)(2m)#
“Nurse aide” has the meaning given in s. 146.40 (1) (d).
(b)#
Reimbursement under s. 20.435 (4) (b), (gm), (o), and (w) for home health services provided by a certified home health agency or independent nurse shall be made at the home health agency’s or nurse’s usual and customary fee per patient care visit, subject to a maximum allowable fee per patient care visit that is established under par. (c).
(c)#
The department shall establish a maximum statewide allowable fee per patient care visit, for each type of visit with respect to provider, that may be no greater than the cost per patient care visit, as determined by the department from cost reports of home health agencies, adjusted for costs related to case management, care coordination, travel, record keeping and supervision.