Physical therapy services
Medicare Coverage Information
Overview
Medicare provides coverage for physical therapy services that are medically necessary and prescribed by a qualified healthcare professional. These services help patients recover from injuries, manage chronic conditions, and improve mobility and function.
- Physical therapy must be medically necessary and ordered by a doctor or healthcare provider
- Covered under Medicare Part B as an outpatient service
- Services include evaluation, treatment, and therapeutic exercises
- Requires documentation of medical necessity and treatment progress
- Can be provided in various settings like clinics, doctor's offices, and some home health scenarios
- Medicare Part B beneficiaries
- Patients with a qualifying medical condition requiring rehabilitation
- Services prescribed by a qualified healthcare professional
- Beneficiaries typically pay 20% of the Medicare-approved amount after meeting the Part B deductible
- No copayment required for initial evaluation
- Annual therapy caps have been removed, but medical necessity must be documented
- Services must be deemed medically necessary by Medicare standards
- Requires ongoing documentation and physician certification
- Cosmetic or maintenance-only therapies are generally not covered
- Limited to treatments that show potential for functional improvement
- Consult with your primary care physician about physical therapy needs
- Get a formal referral and prescription for physical therapy
- Verify coverage and potential out-of-pocket costs with your Medicare plan
- Contact Medicare at 1-800-MEDICARE for specific coverage questions
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare physical therapyphysical therapy coverageMedicare Part B therapy servicesrehabilitation servicesoutpatient therapy
Related Coverage Topics
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