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Services provided to homebound injured workers vary widely.

• Home health care services provided to injured workers range from short-term care following an acute episode to longer-term nursing care and supportive services for seriously disabled workers who would otherwise be institutionalized.

Fee schedules for other public health care programs provide useful options for a WC home health services schedule.

• Allowances differ by the level of training/licensure and employer of the care provider.
• Time-based rates are lower for an eight-hour shift than for services performed over shorter time periods.
• Estimated costs of in-home services come with an aggregate monthly cap.

There are several viable ways to structure a home health services fee schedule.

• The largest question to be addressed is that of services performed by family members.
• IHSS has useful rules on family member services, and other programs furnish few models.

Fraud and abuse must be anticipated and avoided.

• Most state WC programs that cover supportive services limit coverage to personal care services and rely on preauthorization and time-limited authorizations.

Multiple billing forms will likely need to be adopted.

• Billing codes adopted from other programs would have both duplications and gaps.
• Separating Medicare-based rules from IHSS-based rules will be a complicated undertaking. Specificity and attention to detail will be vital.