Does Medicare Cover Physical Therapy?
Does Medicare cover physical therapy? Learn what Medicare will cover and what costs you may have to pay.
Yes, Medicare Part B does cover some physical therapy and occupational therapy services if they are considered medically necessary by a physician.
However, Medicare caps the number of physical therapy treatments you can receive, and you may still be responsible for certain out-of-pocket costs.
A Medicare Supplement (Medigap) plan can help cover your physical therapy costs, such as Medicare deductibles, copays, coinsurance and more.
When Does Medicare Pay for Physical Therapy?
Medicare Part B does cover physical therapy in a variety of outpatient settings, including:
The offices of private practitioners
Outpatient hospital departments, including critical access hospitals
Skilled nursing facilities
At home, from providers that include privately practicing therapists and home health agencies
How Much Does Physical Therapy Cost With Medicare?
It's important to remember that under Medicare Part B, you'll still have to pay part of the costs of services. Some of your Medicare Part B out-of-pocket costs include:
Medicare Part B deductible — $240 per year in 2024
Medicare Part B coinsurance — 20 percent of all Medicare-approved costs of service
Medicare Physical Therapy Cap 2023
Although Medicare Part B covers some physical therapy services, it limits the amount of physical therapy you can receive. In 2024, these “therapy caps” are:
$2,330 for physical therapy and speech-language pathology services, combined
$2,230 for occupational therapy services
You may be able to secure an exemption from these caps. To qualify for an exemption, your therapy provider must recommend your need for additional services, as documented in your medical records. They must also indicate that the services are medically necessary and reasonable.
Under these conditions, Medicare will generally pay its share of physical therapy costs beyond the therapy cap.
Understanding Physical Therapy Services
Physical therapy is a proven form of health care that:
Reduces chronic pain
Treats injuries and other kinds of movement problems
Helps minimize the need for surgery
Allows many patients to avoid prescription drugs
Is often tailored to patients' individual needs, and is a collaboration between physical therapists and patients
Physical therapy addresses a wide range of physical ailments, from Achilles tendon injuries to the symptoms of vertigo. And because it serves as an alternative to surgery, physical therapy can be a lower-cost health option for those suffering from pain.
Learn more about common procedures that medicare covers.
Does Medicare Supplement Insurance Plans Cover Physical Therapy?
Medicare Supplement (Medigap) plans help with Part A and Part B costs, including physical therapy under Medicare Part B.
Private insurers offer standardized Medicare Supplement plans, like Plan G in most states. Different insurers' Plan G offers similar benefits, often covering Part B coinsurance, including physical therapy.
However, three states (Massachusetts, Minnesota, and Wisconsin) have distinct standardized plans.
Medicare Part B covers physical therapy, with 80/20 cost-sharing. Many Medicare Supplement plans fully cover Part B coinsurance for services like physical therapy, while some cover part of it.
Medicare Supplement Insurance can help cover your out-of-pocket physical therapy costs.Find a plan Or call to speak with a licensed insurance agent.