Does Medicare Cover Physical Therapy?

Medicare will pay for your physical therapy if your doctor decides it is medically necessary to treat your injury or illness. Physical therapy is covered under Medicare whether it is as an inpatient, outpatient or at home. Medicare Part B does not limit how much it will pay for outpatient physical therapy in a given year.

Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

    Read More
  • Edited By
    Matt Mauney
    Matt Mauney, Senior Editor for RetireGuide

    Matt Mauney

    Financial Editor

    Matt Mauney is an award-winning journalist, editor, writer and content strategist with more than 15 years of professional experience working for nationally recognized newspapers and digital brands. He has contributed content for ChicagoTribune.com, LATimes.com, The Hill and the American Cancer Society, and he was part of the Orlando Sentinel digital staff that was named a Pulitzer Prize finalist in 2017.

    Read More
  • Published: August 31, 2020
  • Updated: October 13, 2023
  • 7 min read time
  • This page features 7 Cited Research Articles
Fact Checked
Fact Checked

Our fact-checking process starts with vetting all sources to ensure they are authoritative and relevant. Then we verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page.

Cite Us
How to Cite RetireGuide.com's Article

APA Turner, T. (2023, October 13). Does Medicare Cover Physical Therapy? RetireGuide.com. Retrieved November 21, 2024, from https://www.retireguide.com/medicare/treatments/pain-management/physical-therapy/

MLA Turner, Terry. "Does Medicare Cover Physical Therapy?" RetireGuide.com, 13 Oct 2023, https://www.retireguide.com/medicare/treatments/pain-management/physical-therapy/.

Chicago Turner, Terry. "Does Medicare Cover Physical Therapy?" RetireGuide.com. Last modified October 13, 2023. https://www.retireguide.com/medicare/treatments/pain-management/physical-therapy/.

Why Trust RetireGuide.com
Why You Can Trust Us

Content created by RetireGuide and sponsored by our partners.

Key Principles

RetireGuide’s mission is to provide seniors with resources that will help them reach important financial decisions that affect their retirement. Our goal is to arm our readers with knowledge that will lead to a healthy and financially sound retirement.

We’re dedicated to providing thoroughly researched Medicare information that guides you toward making the best possible health decisions for you and your family.

RetireGuide LLC has partnerships with Senior Market Sales (SMS) and GoHealth.

Our partners are able to be reached through the phone numbers and/or forms provided on our website.

The content and tools created by RetireGuide adhere to strict Medicare and editorial guidelines to ensure quality and transparency.

Editorial Independence

While the experts from our partners are available to help you navigate various Medicare plans, RetireGuide retains complete editorial control over the information it publishes.

We operate independently from our partners, which allows the award-winning RetireGuide team to provide you with unbiased information.

Visitors can trust our inflexibility regarding our editorial autonomy. We do not allow our partnership to influence RetireGuide’s editorial content whatsoever.
Physical Therapy Coverage at a Glance
Medicare PlanPhysical Therapy Coverage
Part A (Inpatient)Covered, but you have a $1,676 deductible and you have to pay coinsurance after 60 days of inpatient care.
Part B (Outpatient)80% after you pay the Part B deductible — $257.
Part C (Medicare Advantage)Coverage is at least equal to Part B. Some plans may offer additional benefits.
Part D (Prescription Drugs)N/A
Supplemental InsuranceCoverage may offset out-of-pocket costs under Original Medicare. Coverage varies by plan.

When Does Medicare Cover Physical Therapy?

Physical therapy, sometimes called PT, uses specially designed equipment and exercises to help you regain or improve your previous physical abilities. Physical therapists are specially trained health care professionals who use massage, heat treatments and exercise to relieve pain and treat injuries, diseases or physical deformity in patients.

Medicare covers part of the cost of your physical therapy only if your doctor determines that the treatment is medically reasonable and necessary.

Did You Know?
Medicare Part A covers medically necessary inpatient procedures, but you will still be responsible for any deductible, coinsurance and copayments. Medicare Part B covers 80% of the costs of medically necessary outpatient physical therapy after you’ve met your deductible. Medicare Part B also covers at-home physical therapy from certain providers.

If the treatment is recommended by a physical therapist, but not ordered by a doctor, Medicare will not pay.

A physical therapist or other therapy provider must give you a written notice called an “Advance Beneficiary Notice of Noncoverage” if your therapy is not medically necessary.

This will let you know that Medicare will not cover physical therapy in your case. You will be required to pay the full cost.

Tip
If you have questions about whether your physical therapy will be covered, or what your costs may be, you can call Medicare at 1-800-633-4227 (TTY users can call 1-877-486-2048). You can also call your State Health Insurance Assistance Program (SHIP) for free, personalized health insurance counseling.
Source: U.S. Centers for Medicare & Medicaid Services

Medicare Coverage for Inpatient Physical Therapy

Medicare Part A covers medically necessary inpatient physical therapy at inpatient rehabilitation facilities — sometimes called an inpatient “rehab” facility (IRF), acute care rehabilitation center or rehabilitation hospital.

You will still be responsible for a deductible, coinsurance and copayments.

Your Costs When Medicare Covers Physical Therapy 2025
Days 1 to 60
$1,676 deductible (unless you’ve already met your deductible in this benefit period.)
Days 61 to 90
$419 coinsurance each day.
Days 91 and beyond
$838 coinsurance for each “lifetime reserve day.” You have 60 of these over your lifetime.
Each Day After Your Lifetime Reserve Days
You will be responsible for all costs.

Your doctor may order inpatient rehabilitation to help you recover from a serious injury such as a fall or accident or for a serious illness such as Parkinson’s disease that requires an intensive rehabilitation therapy program.

Inpatient Physical Therapy Costs Medicare Covers
  • A semi-private room
  • Meals
  • Medications
  • Nursing services
  • Physical therapy services
  • Other hospital services and supplies

Doctor’s services you receive while in an inpatient physical therapy facility are paid by Medicare Part B.

Medicare Coverage for Outpatient Physical Therapy

Medicare Part B medical insurance covers 80% of the costs of medically necessary outpatient physical therapy after you’ve met your Part B deductible — $257 in 2025. You are responsible for 20% of the Medicare-approved outpatient service amount.

Where Medicare Covers Outpatient Physical Therapy Services
  • Comprehensive outpatient rehabilitation facilities
  • Medical offices
  • Offices of privately practicing physical therapists
  • Outpatient departments in general hospitals or critical access hospitals
  • Rehabilitation agencies, sometimes called other rehabilitation facilities (ORFs)
  • Skilled nursing facilities when Medicare Part A doesn’t apply
  • At home in some cases

In the past, Medicare Part B had a cap on how much it would pay each year for your outpatient physical therapy. The agency eliminated the cap in 2018. There is no longer any limit on how much it will pay for medically necessary outpatient PT under Medicare Part B. This may be different if you have a Medicare Advantage plan.

Medicare Advantage plans are sold and administered by private insurers. You may be limited to using physical therapists and facilities within your Medicare Advantage plan’s network. Check your plan’s coverage rules regarding physical therapy services.

 

Have you selected your 2024 Medicare plan?
Maximize your Medicare savings by connecting with a licensed insurance agent. Annual Enrollment is open until December 7th.

Does Medicare Cover In-Home Physical Therapy?

Medicare Part B medical insurance will cover at home physical therapy from certain providers including private practice therapists and certain home health care providers.

If you qualify, your costs are $0 for home health physical therapy services. But you will pay 20% of the Medicare-approved amount for durable medical equipment — wheelchairs, walkers and other such medical devices and equipment.

You have to have Medicare Part A and/or Part B and meet all items on a list of requirements from Medicare to be eligible for at home therapy.

Medicare Eligibility for Home Physical Therapy Coverage
  • You must be under the care of a doctor.
  • You must have a plan of care your doctor created and regularly reviews.
  • A doctor must certify that you need one or more of these:
    • Intermittent skilled nursing care other than drawing blood.
    • Physical therapy scheduled over a reasonable time frame that is specific, safe and effective treatment for your condition by a Medicare-approved provider.
    • That you are homebound.

You are not eligible for home PT services if you need more than part-time skilled nursing care. You may still get home services if you attend adult day care. You may still be considered homebound even if you leave home for medical treatment or short, rare nonmedical reasons such as attending religious services.

Medicare Advantage and Medigap Physical Therapy Coverage

Since Medicare Advantage plans are required to cover everything Original Medicare covers, your plan should at least cover what Medicare Part A and Part B covers for physical therapy.

You should ask your plan administrator if your Medicare Advantage plan provides additional physical therapy coverage. Some plans may offer dental, vision, or fitness plans in addition to physical therapy.

You may want to consider a Medicare Supplement plan (Medigap) if you are worried about out-of-pocket costs for PT. Medigap policies can help with copayments.

Be aware, you cannot buy both a Medicare Advantage plan and a Medigap plan. You are limited to one or the other.

Medicare Coverage of Physical Therapy FAQs

What is a good physical therapy service that accepts Medicare for in-home seniors?
You can ask your doctor to recommend a home health care physical therapist or you can check the website for the American Physical Therapy Association (APTA). In either case, make sure the service or therapist accepts Medicare. If you have Medicare Advantage, you may have to use a therapist in your plan’s network.
What is the Medicare physical therapy cap for 2023?
Medicare no longer enforces a cap on the number of physical therapy sessions you can have in a single year. The combined total Medicare will spend for physical therapy and speech and language therapy is $2,230 in 2023. Once you hit that amount, Medicare will review your case to ensure that physical therapy is medically necessary. You may also have to pay a Medicare deductible and coinsurance.
How many days does Medicare pay for physical therapy?
There is no limit on the number of days of physical therapy covered under Medicare, but doctors can only authorize up to 30 days at a time. After 30 days, your doctor has to reauthorize physical therapy for Medicare to continue covering it.
Never Miss Important News or Updates with Our Weekly Newsletter
Get money-saving tips, hard-to-find info and tactics for a successful retirement in our free weekly newsletter.
Last Modified: October 13, 2023

7 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
  2. U.S. Centers for Medicare & Medicaid Services. (2020, November 6). 2021 Medicare Parts A and B Premiums and Deductibles. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2021-medicare-parts-b-premiums-and-deductibles
  3. U.S. Centers for Medicare & Medicaid Services. (2022). Medicare and You Handbook 2022. Retrieved from https://www.medicare.gov/Pubs/pdf/10050-medicare-and-you.pdf
  4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Physical Therapy. Retrieved from https://www.medicare.gov/coverage/physical-therapy
  5. U.S. Centers for Medicare & Medicaid Services. (n.d.). Inpatient Rehabilitation Care. Retrieved from https://www.medicare.gov/coverage/inpatient-rehabilitation-care
  6. U.S. Centers for Medicare & Medicaid Services. (n.d.). Home Health Services. Retrieved from https://www.medicare.gov/coverage/home-health-services
  7. AARP. (n.d.). Does Medicare Cover Physical Therapy? Retrieved from https://www.aarp.org/health/medicare-qa-tool/does-medicare-cover-physical-therapy/