Medical Necessity

Medical Necessity 

When we care for patients whose charges are reimbursed by Medicare, we must adhere to Medicare laws and requirements in order to receive payment. The Medicare system requires providers to document “medical necessity” for any care we provide as its very first criteria. Medical necessity provides proof the resident needs the covered services we provide in the setting we provide them. It is the foundation on which all covered care decisions are based, and begins even before the resident is physically admitted to our care. This course will cover how residents are assessed for this important criteria and how medical necessity flows throughout the course of treatment up to, and including, discharge from our care.


Hours: 1.00


Certificates provided by accrediting body (2 Match)

Missouri Health Care Association


This on-line activity has been approved for 1.00 Patient Care Hour(s) toward the Missouri continuing education requirement for nursing home administrators. Relias LLC offers courses approved by the Missouri Health Care Association, an approved training agency, TA-002-919, by the Missouri Board of Nursing Home Administrators. This activity is approved for 1.00 contact hours.

National Association of Long Term Care Administrator Boards (NHA)

1.25 HOURS

This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.25 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]
Hours type - NHA: Resident Care Hours

Course Details

Course Code: REL-RED-L2J
Hours: 1
Type: Online Course
Content Expiration Date: 7/31/2021
Learning Objectives:
Describe four conditions that must be met for Medicare to cover the provision of care
Give three requirements for physical therapy to be covered by Medicare
Give three requirements for speech pathology therapy to be covered by Medicare
Give three requirements for occupational therapy to be covered by Medicare

Defining Medical Necessity Physical Therapy: Covered and Uncovered Services Speech Therapy: Covered and Uncovered Services Occupational Therapy: Covered and Uncovered Services Terminology

Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form ( or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.