Medicare home health gap for occupational therapy would close under HR 2013

What does this do?

HR 2013 adds occupational therapy to the list of services that can qualify a Medicare patient for covered home health services. Under current law, only skilled nursing care, physical therapy, or speech therapy can establish that eligibility. The change would take effect January 1, 2026.

Who does it affect?

Medicare beneficiaries — generally adults 65 and older, plus some younger people with disabilities — who need occupational therapy at home but do not qualify under the current rules are the primary group affected. Home health agencies and occupational therapists serving Medicare patients would also be affected, as more patients could become eligible for their services.

Why does it matter?

Under current law, a patient who needs only occupational therapy at home cannot receive Medicare coverage for it unless they also need one of the other qualifying services, creating a gap in coverage. Removing that restriction would expand the pool of Medicare patients who qualify for home health services.

Where does it stand?