Does Medicare cover physical therapy?
Medicare Part B covers medically necessary outpatient physical therapy, and you pay 20% of the Medicare-approved amount after the Part B deductible with no hard dollar cap.
What flips the answer
- Covered when
The therapy is medically necessary with a documented plan of care — covered even past the reporting threshold when the need is justified.
- Covered when
You get PT during a covered inpatient hospital or skilled nursing stay, or through the home health benefit if you're homebound and qualify.
- Not covered when
The therapy has become maintenance or general fitness that doesn't require the skills of a licensed therapist.
Original Medicare (Part B) covers outpatient physical therapy when it's medically necessary to treat your condition and a doctor or therapist sets up and periodically reviews a plan of care. After you meet the Part B deductible, you generally pay 20% of the Medicare-approved amount.
The old annual 'therapy cap' no longer cuts off coverage. There's still a threshold above which the provider must confirm and document that continued therapy is medically necessary, but there's no fixed dollar limit that ends your benefit.
Physical therapy is also covered in other settings under the right conditions — during a covered inpatient hospital or skilled nursing facility stay (Part A), and at home as part of the home health benefit if you're homebound and qualify.
What isn't covered is therapy that stops being medically necessary — for example, general fitness or maintenance exercise you could do on your own without a skilled therapist's involvement.
That's the general answer. Yours is written in your actual policy.
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