Does Medicare Cover Physical Therapy?

The short answer: Yes — Original Medicare covers physical therapy under Part B when a doctor or therapist certifies it is medically necessary, and there is no longer any hard annual cap on how much therapy you can receive. Above a yearly threshold, your therapist simply documents that continued care is necessary — a paperwork checkpoint, not a cutoff. You pay Part B’s normal cost-sharing, which a supplement can absorb.

How the coverage actually works

Outpatient physical therapy — after a fall, a joint replacement, a stroke, or for a condition that simply needs strengthening — is covered under a plan of care your doctor or therapist establishes and periodically reviews. The old annual “therapy cap” that families still ask about was eliminated years ago; what remains is a threshold amount after which the therapist adds documentation confirming medical necessity. For patients this is invisible; care continues.

Therapy can also arrive through home health when you qualify as homebound and a doctor orders it — a different benefit with its own rules, and often the right one after a hospitalization. And skilled nursing facility stays following a qualifying hospital admission include therapy as part of Part A’s coverage.

What you’ll pay

Under Original Medicare alone: after the Part B deductible, Medicare pays 80% of the approved amount and you owe 20% per session — which adds up across a months-long course of therapy. A Medigap plan picks up that coinsurance, turning a long rehabilitation into a non-event financially. Medicare Advantage plans cover therapy with their own copays and often require prior authorization and in-network providers — worth confirming before starting a course of care.

Common questions about Medicare and physical therapy

How many PT sessions does Medicare allow per year?

There is no session limit. Coverage continues as long as care is medically necessary and documented — the annual threshold triggers extra paperwork for the therapist, not an end to your treatment. Anyone telling you Medicare “ran out” of therapy visits is describing the old rules, or a plan’s rules, not Original Medicare’s.

Do I need a referral to start physical therapy?

Under Original Medicare you can generally begin evaluation directly, but continuing care requires a plan certified by a doctor or qualified provider — in practice, your physician is involved early. Medicare Advantage plans may add their own referral and authorization requirements; check the plan’s rules first.

Is therapy for a chronic condition covered, or only for recovery?

Both. Coverage does not require that you be improving — maintenance therapy to preserve function or slow decline is covered when it requires a therapist’s skill. That standard was settled years ago, though families are still sometimes told otherwise; documentation, not improvement, is the requirement.

The simple version

Medically necessary PT: covered, without session caps, at Part B’s usual cost-sharing. The planning question is only how your 20% gets handled — see what Medicare costs and the two ways people structure it. Related: chiropractic coverage, where the rules are far narrower.

Questions about your own coverage? Call or text 770-765-7007 — plain-language answers at no cost. We’re based in Cumming, Georgia, working with families across North Georgia — and licensed in states across the country.