Yes. Medicare covers physical therapy that’s considered medically necessary to treat an injury or illness, such as to manage a chronic condition like Parkinson’s disease or aid recovery from a fall, stroke or surgery. Medicare also covers:
- Occupational therapy, which helps with daily living activities, such as bathing, dressing and eating.
- Speech-language pathology, which provides evaluation and treatment to regain and strengthen speech and language skills.
What inpatient physical therapy does Medicare cover?
Medicare Part A covers inpatient stays in hospitals, skilled nursing facilities and some home care, as well as physical therapy at inpatient rehabilitation facilities. It also may cover in-home services if you’re eligible for home care, or services you receive at a skilled nursing facility after a three-day hospitalization.
Your out-of-pocket costs, such as deductibles and coinsurance, depend on the treatment setting. For example, your share of the cost is different if you receive inpatient care in a hospital versus at a skilled nursing facility.
What outpatient physical therapy does Medicare cover?
If you require skilled therapy services, Medicare covers outpatient therapy services, including occupational therapy, physical therapy and speech-language pathology. But your doctor or therapist must create and regularly review the care plan.
Medicare Part B will cover outpatient physical therapy once you pay the annual Part B deductible for doctor and outpatient services, which is $226 in 2023. You’ll also pay 20 percent of the Medicare-approved amount for outpatient occupational therapy, physical therapy and speech-language pathology received at:
- A doctor’s or therapist’s office.
- A hospital outpatient department.
- An outpatient rehabilitation facility.
- A skilled nursing facility if you’re being treated as an outpatient or are ineligible for a Medicare-covered stay.
- Home if a Medicare-certified home health agency provides care and you’re ineligible for Medicare Part A home health benefits.
Keep in mind
Medicare previously set an annual maximum payment for outpatient therapeutic services but eliminated that cap in 2018.
While the program no longer limits what it will pay yearly for medically necessary therapy, if your total therapy costs reach a certain amount within a year, your provider must confirm that the therapy is medically necessary. In 2023, that amount is $2,230 for physical therapy and speech language pathology combined, and $2,230 for occupational therapy.
Updated February 9, 2023