Does Medicare cover physical therapy?

Kimberly Lankford,

AARP

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Published September 13, 2022

/ Updated March 22, 2024

In this story

Medically necessary • Inpatient stay • Outpatient setting • MA coverage • Keep in mind

Yes. Medicare Parts A and B cover physical therapy considered medically necessary to treat an injury or illness, including managing a chronic condition like Parkinson’s disease or aiding recovery from a fall, stroke or surgery. Medicare also covers:

Occupational therapy, which helps with activities of daily living, 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.

Pain management

Your out-of-pocket costs, typically a deductible and coinsurance, depend on the treatment setting, such as inpatient care in a hospital versus at a skilled nursing facility.

What outpatient physical therapy does Medicare cover?

If your doctor or other provider certifies that you need skilled therapy services, Medicare Part B covers outpatient physical therapy, occupational therapy and speech-language pathology. But your doctor or therapist must create and regularly review the care plan.

Part B coverage for outpatient physical therapy begins once you’ve met your annual Part B deductible for doctor and outpatient services, which is $240 in 2024. You’ll also pay 20 percent of the Medicare-approved amount for outpatient occupational therapy, physical therapy and speech-language pathology services from the following:

Doctor’s or therapist’s office.

Hospital outpatient department.

Outpatient rehabilitation facility.

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.

Does Medicare Advantage cover physical therapy?

Private Medicare Advantage plans must cover the same services as original Medicare, but often have different out-of-pocket costs and conditions. For example, you may have a $10 to $40 copayment for physical or occupational therapy visits, need to use an in-network provider and receive prior authorization from the plan before therapy is covered.

You can check out physical therapy coverage for Medicare Advantage plans in your area by using the Medicare Plan Finder. Find a list of plans available in your zip code, click Plan Details | Benefits and costs and scroll down to therapy services to see copayments for physical, occupational, speech and language therapy. Click plan website under the plan’s name and search for the plan’s Summary of Benefits for more information.

Keep in mind

Medicare eliminated its annual maximum payment for outpatient therapeutic services cap in 2018.

While the program no longer limits what it will pay yearly for therapy services, if your annual therapy costs reach a certain threshold, your provider must confirm that the therapy is medically necessary. In 2024, that amount is $2,330 for physical therapy and speech language pathology combined, and $2,330 for occupational therapy.

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Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.