Occupational therapy services
Medicare Coverage Information
Overview
Medicare provides coverage for occupational therapy services that are medically necessary to help patients improve, maintain, or restore daily living skills after an illness, injury, or disability. These services are typically covered under Medicare Part B and require a physician's certification of medical necessity.
- Covered under Medicare Part B as an outpatient service
- Must be prescribed by a qualified healthcare professional
- Services must be medically necessary and part of a treatment plan
- Helps patients regain independence in daily activities
- Can be provided in various settings like clinics, hospitals, and home health
- Medicare Part B beneficiaries
- Patients with a qualifying medical condition
- Referral from a physician or healthcare provider
- Individuals needing rehabilitation or skill restoration
- 20% coinsurance after meeting Part B deductible
- Patients responsible for remaining costs after Medicare coverage
- Additional costs may vary depending on specific treatment and location
- Requires physician certification of medical necessity
- Limited annual therapy cap may apply
- Services must be deemed reasonable and necessary
- Specific documentation and progress reporting required
- Consult with your primary care physician about therapy needs
- Get a detailed referral and treatment plan
- Verify coverage with your specific Medicare plan
- Contact Medicare at 1-800-MEDICARE for detailed information
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare occupational therapyrehabilitation servicesMedicare Part B therapymedical therapy coverageMedicare rehabilitation
Related Coverage Topics
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