Active vs. Maintenance in Medicare
Recognize the Differences Between Active and Maintenance Care
One of the most difficult concepts for providers to grasp is the fine line that exists between the necessity of active treatment and when the care would be deemed maintenance. This distinction is critically important because declaring a visit to be medically necessary, therefore billable to and payable by Medicare, has compliance implications. At KMC University, we believe that this concept…knowing this difference, is one of the most important pieces of business knowledge that providers and team members can know. It’s the difference between risk and safety. This graphic image highlights several important facts that distinguish active care from maintenance care.