🔹 Rates 🔹
In-Home Assessment
$100/hr
Initial Assessment:
15-30-min intake call (free)
2+ hour home visit (Portland/Vancouver Metro)
1 hour drive time
Custom written report (2+ hours)
Follow-up Q&A
(Approx. 4-6 hours total - final cost may vary based on square footage, medical complexity, and project scope.)
Accessibility Design
$100/hr
In-Home Assessments & Virtual Walkthroughs
Zoom Consultations
Accessibility-Focused Space Planning & Design
Product Sourcing & Recommendations
Team Coordination with Architects, Designers, Contractors & Healthcare Providers
Guidance on Home Sharing & Multigenerational Living
Homeowner’s Representative
$100/hr
Project Coordination & Oversight
Contractor Communication & Advocacy
Timeline & Milestone Tracking
On-Site Coordination for Accessibility Projects
Reviewing Estimates & Bids
Vetting Contractors & Trade Professionals
Ensuring Accessibility Features are Properly Integrated
SERVICES FOR ATTORNEYS & LIFE CARE PLANNERS
$150/hour
Expert Occupational Therapy assessments for attorneys and Life Care Planners
Case-specific reports & documentation
Home safety evaluations & accessibility reviews
Cost projections for care and modifications
Consultations to support injury claims, accommodations, and legal proceedings
Veteran Discount: for all services
$65/hour
Concierge Packages & Flat-Rate Options Available
Travel time is factored into service planning and discussed in advance.
🔹 PLEASE PAY here 🔹
(Venmo, Paypal, Zell, Stripe, Square) kelly-nesbitt.squarespace.com/payment
🔹 MEDICARE NOTE🔹
Why I Don’t Bill Medicare - and What That Means for You
I’m fully licensed in OR/WA, but I do not bill Medicare. Here’s why:
Medicare favors high-volume clinics with brief, standardized visits. It does not reimburse for the in-depth, on-site work I do - such as home assessments, design planning, contractor collaboration, travel, or detailed care coordination.
Behind the scenes, I spend hours reviewing records, planning, coordinating, and ensuring compliance. Under Medicare, this time is unpaid, making my work unsustainable in a one-person practice.
Coverage limits:
Part A: Only for homebound patients under strict medical criteria, and OT cannot be the sole discipline.
Part B: Pays for face-to-face therapy only - planning, travel, and collaboration are excluded.
By operating as private pay, I can provide high-touch, personalized service without rushing or cutting corners. I can provide a Superbill for you to seek potential reimbursement from your insurance.
If you specifically need a Medicare Part B in-home OT, check Medicare’s Care Compare and call local Home Health agencies individually to see if they offer Part B Home OT for Home Safety Assessments. These visits are typically brief, less flexible, and assigned rather than chosen.
What Medicare Does and Does Not Cover:
Medicare may cover a few durable medical items, such as a walker or basic wheelchair, typically every five years and only when prescribed by a doctor.
Medicare Does Not Cover:
Home remodels (e.g., widening doorways, ramps, roll-in showers)
Grab bars or safety rails
Shower chairs, bath benches, or handheld shower heads
Stair lifts, ceiling lifts, or hospital beds used for comfort
Smart home upgrades or fall-prevention modifications
Long-term caregiver support (e.g., bathing, dressing, meal prep)
Assisted living or long-term housing costs
To explore official Medicare guidelines, visit:
Otherwise, we provide assistance with identifying funding sources (grants, loans, long term care insurance benefits, financing options, Veteran benefits), and connect clients with vetted professionals (see below).
FUNDING SOURCES
🔹 Grants 🔹
VA Specially Adapted Housing (SAH) Grant – For eligible veterans with service-connected disabilities.
VA HISA Grant – For medically necessary modifications.
HUD Home Modification Grants – Offered through local housing authorities.
Community Development Block Grants (CDBG) – Local government-administered support for accessibility upgrades.
Rebuilding Together / Habitat for Humanity – Free or low-cost repairs for income-qualified seniors.
Area Agencies on Aging (AAA) – May offer minor home repair funds.
Utility Company Assistance Programs – May include accessibility improvements under energy efficiency support.
🔹 Government & Public Programs🔹
Medicaid Waivers (HCBS) – In select states, may cover home modifications.
State Assistive Technology Programs – Offer funding, equipment loans, and referrals.
USDA Section 504 Loans & Grants – For low-income, rural homeowners (age 62+ for grants).
🔹 Loans & Lines of Credit🔹
Home Equity Line of Credit (HELOC) – Flexible option using home equity.
Home Equity Conversion Mortgage (HECM) – Reverse mortgage for adults 62+.
Personal Loans / Credit Unions – Useful for smaller or short-term projects.
🔹 Private Insurance / Legal / Employer Benefits🔹
Long-Term Care Insurance – May reimburse accessibility upgrades
Worker’s Comp / Legal Settlements – May cover injury-related modifications
Employer or Union Retiree Benefits – May include stipends or support for aging-in-place needs.
Disclaimer: Consultant is not a general contractor or architect. Recommendations are based on clinical and accessibility expertise. Final decisions and code compliance are the responsibility of licensed professionals.