Does Medicare cover physical therapy?

Physical therapy is just 1 form of physical rehabilitation. (Others include occupational therapy and speech/language therapy.) Physical therapy, or “PT,” uses exercise, stretching and controlled movements to help patients reduce their pain and increase strength and mobility after an illness, injury or surgery. Whether you’re working with a licensed physical therapist in a professional facility or following a plan for recovery in your own home, physical therapy can be critical to achieving your best health. 

Medicare is divided into different parts. Depending on your plan choices, 1 or more of them may help cover the costs of physical therapy.*

• Medicare Part A (hospital insurance) helps cover any medically necessary care you get as an in-patient, like a semi-private room and other hospital services and supplies.
• Medicare Part B (medical insurance) helps cover doctors’ services, outpatient rehabilitation services, including physical therapy, occupational therapy and speech-language pathology, and prescriptions related to your care. 
• Medicare Part C (Medicare Advantage) provides all the benefits of Original Medicare Part A and Part B and depending on the plan you choose,  may offer additional benefits like a free gym membership.
• Medicare Part D helps cover drugs prescribed by your doctor, which may include pain medication, anti-inflammatories or other medicine to help in your recovery. 

If you opt for Original Medicare (Parts A and B), you may consider purchasing a stand-alone Medicare Supplement  plan to help pay for out-of-pocket costs like deductibles, copayments and coinsurance. 

*To be eligible for benefits, your doctor must certify that you have a medical condition that needs intensive rehabilitation. You must also require continued medical supervision and coordinated care from your doctors and therapists.

The amount you pay can depend on any other insurance you may have and the type of facility you use. You’ll need to satisfy your Part A and Part B deductibles, as well. 

Whether you’re looking at a quick recovery or long-term schedule of physical therapy, ask questions before your therapy starts so you’re clear on how much it will cost.

Inpatient care will be limited by your Medicare Part A benefits . Coinsurance payments for Part A during a hospital or Skilled Nursing Facility (SNF) stay are:

• 1–60 days: $0 copay for each benefit period
• 61–90 days: $434 copay per day in each benefit period
• 91 days and after: $868 copay per each lifetime reserve day

There's no limit on how much Medicare may pay for your outpatient therapy services in 1 calendar year, as long as your doctor or other healthcare provider certifies that it is medically necessary. 

On the other hand, your doctor may also recommend services that Medicare doesn’t cover, like massage therapy or joining a gym. It’s best to know ahead of time exactly what your Medicare benefits include. 

Yes, Part B (medical insurance) helps pay for medically necessary outpatient physical therapy. 

The amount you pay may depend on any other insurance you may have and the type of facility you use. Your doctor may also recommend services that Medicare doesn’t cover or suggest that you get services more often than Medicare allows based on your condition. Be sure to ask questions before your therapy starts so you’re clear on how much you’ll eventually need to pay. 

Whether you need to recover from a recent medical event or you’re dealing with a chronic physical condition, physical therapy can be critical to helping you achieve and maintain your best health. Be sure to take advantage of all the benefits your Medicare coverage  offers.