Physical Therapy is an alternative treatment before and after surgery to help heal and prevent further injury, as well as care after a serious illness such as a stroke. Physical therapy costs can really add up, especially if you need care for a long period of time. So does Medicare cover it and how much does it cover?
Does Medicare Cover Physical Therapy?
Yes. Medicare covers physical therapy. At one time there was a maximum payout for physical therapy but it was removed by Congress in 2018. Now Medicare Part B helps pay 80% of medically necessary outpatient physical therapy.
Medicare used to cap outpatient physical therapy, speech-language pathology, and occupational therapy with a yearly dollar limit. That hard cap is gone, but Medicare still tracks yearly threshold for these services. Once your approved charges reaches $2,480 , your therapist has to document that continuing therapy is medically necessary for Medicare to keep paying its share. (source)
You are still responsible for your Medicare Part B deductible, your 20% coinsurance and any excess charges.
Does Medigap Cover Physical Therapy?
All Medigap plans pay for all or part of your physical therapy coinsurance and copays. However, only Medigap Plans C and F cover your Part B deductible. Plan F and Plan G will cover all excess charges as well.
Does Medicare Advantage Cover Physical Therapy?
Medicare Advantage (MA) does cover physical therapy. However, since MA plans are not standardized each plan can cover it differently.
For further questions call one of our licensed agents at 800-930-7956 or click here to read our article Does Medicare cover Chiropractic and Acupuncture?