Rehabilitation site | Medical coverage | Therapy services | Nursing | Insurance |
Inpatient rehabilitation (acute) | Clinician available 24 hours/day, 7 days/week; active medical problem(s) requiring clinician supervision with visit 5 or more days/week | PT, OT, and speech therapy available; patients must need 2 or more therapy services and must receive therapy 3 or more hours per day, 5 days per week. A multidisciplinary team conference is required within 4 days of admission and weekly thereafter. | 24-hour care | Medicare Part A: days 1 to 20: 100%; days 21 to 100: 80% plus copayment; >100 days: no coverage |
Skilled nursing facility (subacute/transitional care unit) | Clinician-supervised; clinician evaluation within 2 weeks of admission and every 30 days; clinician available in emergencies | PT and OT available; typically 1 or more session per day | 24-hour care | Same as inpatient rehabilitation |
Long-term acute care hospital | Clinician available 24 hours/day; active/ongoing medical condition requiring clinician-level care (eg, ventilator-dependent) | PT and OT available | 24-hour care | Same as inpatient rehabilitation |
Home therapy/nursing | Clinician referral and recertification every 60 days | PT, OT, and speech therapy available | Home health nursing | Typically 1 to 3 visits per week by OT/PT for 1 to 3 weeks, 1 visit per week with RN, daily home health aid |
Outpatient (hospital or freestanding clinic) | Clinician referral and recertification every 30 days | PT, OT, and speech therapy available | N/A | May be limitations in number of visits per year |
Telehealth (may be utilized to/from any setting for care [eg, hospital, clinic, home], but without crossing state lines) | Episodic and/or as needed; referral parameters not defined | May be utilized for any noninvasive rehabilitation service (PT, OT, speech, rehabilitation medicine) | N/A | Variable, with coverage for use for rehabilitation in the Veterans Health Administration and Medicaid (most states), and with some programs in Medicare and private insurance |
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