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R
ravensdottir Asked May 2021

Can an individual healthcare professional be a Medicare or Medicaid provider?

I've mentioned this a couple of times in posts, based on what I recall when we were looking for resources for my dad.


I was told that we could get a dialysis technician to come and give my dad dialysis - at home or in a small AL facility. The technician would be registered as a provider, so they would be paid by Medicare.


Is that right? Medicare or Medicaid would cover the cost of a healthcare professional - CNA, technician, RN - providing care for a person at home?

97yroldmom May 2021
No actual experience with dialysis here.
However plenty of experience with Medicare paid home health that includes RNs, LVNs, CNAs, OT, PT beyond Part A paid after rehab type services that Joann mentions. Just don’t know about a dialysis tech.
Call agencies and ask. I’m thinking the patient would have to be homebound for starters. Otherwise more people would use home service than going to a dialysis facility, I do know my aunt was transported to a dialysis facility from a rehab and it was extremely difficult for her so there has to be some qualifying factor she didn’t reach if such a service were available. Let us know if you find out.

JoAnn29 May 2021
No, Medicare usually will not pay for a CNA or RN. The only time this is done is when a person has been discharged from the hospital or rehab and a doctor feels they need more care at home. But this is only a temporary thing. Once person has plateaued in therapy or healed Medicare no longer pays. Maybe check out what Igloo said. His doctor should know of any programs.

A dialysis tech is a different thing. This is a service and the company or he/she works for has to acceot Medicare. Same if the tech works for a hospital.

Now Medicaid may pay for a CNA if Dad fits the income requirement. Not sure if they would pay for an RN. Any providers would need to be able to bill Medicaid. And believe me, I find very few that do in my state. Medicaid takes too long to pay providers.

Just curious, what type of dialysis would Dad receive? Would it be
peritoneal dialysis? If so, this is a last ditch effort. My GF had it because her veins could no longer do dialysis from years of juvenile diabetes. Another friend his wife was taught how to do it at home. With both my friends, they passed. Both were tired of it all and chose Hospice. Read up on it.

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igloo572 May 2021
I bet that if it’s care related to ESRD / end stage renal disease, that Medicare has a specific program for in home care. ESRD is a unique special category & payment system for Medicare (so is ALS / Leo Gehrig disease). Like you can get on Medicare before age 66 for ESRD & MLS.

The program pays well & IMO is why we see those Fresinius & Davita dialysis places built past decade.

spiritu May 2021
Medicare yes, with Medicaid, I don't believe so because they contract with group practices because their rules and regulations and audits are so cumbersome, they won't bother auditing a solo practitioner. It was that way for me when I was a solo practitioner

Geaton777 May 2021
Who told you? I would contact Medicare or Medicaid directly to get an accurate answer.
ravensdottir May 2021
That was 10 (!) years ago (can't believe how much time has passed!) I think I'd talked to a dialysis tech about in-home dialysis, thought a Medicare expert confirmed it... 🤷🏽‍♀️

We never got beyond the inquiry stage, so I was hoping someone here had actual experience of it.

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