A performance-based home evaluation, unlike a checklist, involves the client performing and interacting with objects throughout the home.  An assessment, detects areas where safety is a concern, or function is compromised. As the therapist explains and crucially analyzes the dysfunction observed during the assessment, they can make suggestions to modify the task or the environment for the client.

If the environment is modified with adaptive equipment, assistive technology etc., it is important to conduct a follow up assessment. This visit can include but not be limited to, training by the clinician on this new equipment to establish new habits, or education on its proper use. Both examples require additional skilled interventions. Offering solutions combined with self-care and home management training on installed solutions, makes this practice a skilled and billable service under Medicare.