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

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Medicare Coverage for Physical Therapy Services