Does Medicare cover physical therapy?

Short answer: yes. Medicare Part B covers outpatient physical therapy when it is medically necessary to treat your condition, whether that's recovering from a fall, a surgery, or managing a chronic problem. There is no annual limit on how much medically necessary therapy Medicare will pay for. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for each visit. Therapy you receive as a hospital inpatient or during a covered skilled nursing facility stay is paid under Part A instead, and therapy at home can fall under the home health benefit. Each of those paths has its own rules, below.

What does Part B pay, and what do I pay?

Part B pays for physical therapy you receive as an outpatient — in a therapist's office, a hospital outpatient department, or a rehabilitation clinic. Your share, per Medicare's coverage page, is 20% of the Medicare-approved amount after the annual Part B deductible, and Medicare pays the rest. A Medigap policy can pick up some or all of that coinsurance; a Medicare Advantage plan replaces it with the plan's own copay structure. The Medicare costs page carries the current year's deductible figure.

Is there a limit on how many sessions Medicare covers?

No. Medicare no longer has an annual cap on outpatient therapy coverage. What exists instead is a documentation threshold: once your therapy charges pass a yearly amount, your therapist must add a note to the claim confirming the continued therapy is medically necessary. Coverage continues as long as that's true — the threshold is a paperwork checkpoint for the provider, not a cutoff for you. What ends coverage is therapy that is no longer medically necessary, not a session count.

Who has to order or oversee the therapy?

Outpatient therapy runs under a written plan of care that a doctor or other qualified provider reviews and certifies. The therapist evaluates you and builds the plan; the certification is what makes it Medicare-covered therapy rather than a cash-pay service. If the therapy stops matching the plan — or the plan isn't recertified when required — claims can be denied, so it's fair to ask a clinic directly whether your visits are running under a certified plan of care.

Does Medicare cover physical therapy at home?

It can, two ways. If you qualify for the home health benefit — you're under a doctor's plan of care, you need skilled care such as physical therapy, and you're homebound — Medicare covers therapy visits at home with no coinsurance for the visits themselves. If you don't meet home health rules, some outpatient therapists treat patients at home and bill Part B the ordinary way, with the usual 20% coinsurance. Same service, two very different cost pictures — which is why it's worth knowing which benefit is being billed.

What about therapy in a skilled nursing facility?

Therapy during a covered skilled nursing facility stay is part of the Part A stay itself — you don't pay separately for the physical therapy, though the stay has its own qualifying rules and its own daily cost structure after day 20. Once the covered stay ends, continuing therapy shifts to the outpatient rules above.

How is a Medicare Advantage plan different?

A Medicare Advantage plan must cover the same medically necessary therapy services that Original Medicare covers, but it does so on its own terms: a network of therapy providers, a copay per visit instead of the 20% coinsurance, and — commonly — prior authorization or visit-by-visit approval for continued therapy. None of that changes what's covered; it changes the steps between you and the coverage. If your plan denies continued therapy your therapist believes is necessary, that denial can be appealed like any other plan decision.

Does Medicare cover “maintenance” therapy, or only improvement?

Coverage does not require that you be improving. Skilled therapy to maintain your condition or slow decline is covered when it takes a therapist's skill to do it safely and effectively. What Medicare doesn't cover is general exercise, fitness programs, or services that don't require skilled care — that's the actual line, not whether you're getting better.

If you're weighing how therapy costs land under Original Medicare with a Medigap policy versus a Medicare Advantage plan's copays, that's a conversation a licensed agent can walk through with you — free, and with no pressure attached.