For Medicare reimbursement, what must the goals of treatment be?

The goals of treatment for Medicare reimbursement must be restorative in nature. This means that the care provided should aim to improve the patient's functional abilities and quality of life by restoring their health or enabling them to achieve their maximum potential. This focus on restoring function is essential for eligibility under Medicare guidelines, which prioritize services that lead to improvement or maintenance of the patient's current condition.

Restorative goals often include rehabilitation efforts, such as physical therapy, occupational therapy, or other therapies designed to help patients regain lost skills or independence following illness or injury. Medicare emphasizes outcomes that contribute to a patient's ability to function independently in their home, setting clear expectations for the types of services covered.

While preventive, diagnostic, and curative treatments are important in the broader context of healthcare, they do not align specifically with the criteria that Medicare uses to determine eligibility for reimbursement in home health care. The emphasis on restoration ensures that services are not only necessary but also contribute to the overall goal of helping the patient return to a prior level of functioning.