Is Your Physical Therapy Covered by Medicare?
Does Medicare cover physical therapy
Yes. Medicare covers physical therapy that’s considered medically necessary to treat an injury or illness, such as to manage a chronic condition or aid recovery from a fall, stroke or surgery. Medicare also covers:
Occupational therapy, which helps with , such as bathing, dressing and eating.
Speech-language pathology, which provides evaluation and treatment to regain and strengthen speech and language skills. What inpatient physical therapy does Medicare cover
covers inpatient stays in hospitals, skilled nursing facilities and some home care, as well as physical therapy at inpatient rehabilitation facilities. It may also cover in-home services if you’re or services you receive at a after a three-day hospitalization. Your , such as deductibles and coinsurance, depend on the treatment setting. For example, your share of the cost is different if you receive vs. a skilled nursing facility. What outpatient physical therapy does Medicare cover
If you require skilled therapy services, Medicare covers outpatient therapy services, including occupational therapy, physical therapy and speech-language pathology. But your doctor or therapist must create and regularly review the care plan. Medicare Part B will cover outpatient physical therapy once you pay the for doctor and outpatient services, which is $233 in 2022. You’ll also pay 20 percent of the Medicare-approved amount for outpatient occupational therapy, physical therapy and speech-language pathology received at: A doctor’s or therapist’s office. A hospital outpatient department. An outpatient rehabilitation facility. A skilled nursing facility if you’re being treated as an outpatient or are ineligible for a Medicare-covered stay. Home if a Medicare-certified home health agency provides care and you’re ineligible for Medicare Part A home health benefits. Keep in mind
Medicare previously set an annual maximum payment for outpatient therapeutic services but eliminated that cap in 2018. While the program no longer limits what it will pay yearly for medically necessary therapy, if your total therapy costs reach a certain amount within a year, your provider must confirm that the therapy is medically necessary. In 2022, that amount is $2,150 for physical therapy and speech language pathology combined, and $2,150 for occupational therapy. Updated September 13, 2022 More on Medicare
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