Medicare covers rehabilitation for up to 100 days in a skilled nursing facility after a hospital stay, but the length of payment depends on your progress and the type of care you need.

Medicare Part A pays for inpatient rehabilitation in a skilled nursing facility (SNF) only after you have spent at least three consecutive days in a hospital. The clock starts on day one of your SNF stay. Days 1 through 20 are fully covered with no out-of-pocket cost to you. From day 21 through day 100, you pay a daily coinsurance amount (in 2024, this is $194.50 per day, though this figure changes yearly). After day 100 in the same benefit period, Medicare stops paying.

The catch is that you must show progress toward your recovery goals. If Medicare's medical reviewers determine you are no longer making meaningful progress, they can stop payment before day 100. This happens more often than many people expect. You will receive written notice if Medicare decides to end coverage, and you have the right to appeal.

Key Takeaways

  • Medicare Part A covers up to 100 days of skilled nursing facility care after a three-day hospital stay, with full coverage for the first 20 days.
  • From day 21 through day 100, you pay a daily coinsurance amount that Medicare sets each year.
  • Medicare can stop paying before day 100 if you stop making progress toward your rehabilitation goals, even if your doctor thinks you need more time.
  • Outpatient rehabilitation (physical therapy, occupational therapy, speech therapy) has different limits and is covered under Part B, not Part A.
  • You have the right to appeal if Medicare denies continued coverage or stops payment before day 100.

What "Progress" Means and When Medicare Stops Paying

Medicare does not measure progress the same way your doctor might. The program looks for functional improvement — can you walk farther than you could five days ago, or use your arm more than before? If your therapy notes show you are maintaining your current level but not improving, Medicare may decide you no longer need skilled care and will deny payment.

This decision is made by Medicare's utilization review contractors, not by your doctor or the facility. You will receive a notice called an Advance Beneficiary Notice (ABN) before Medicare stops paying. This notice tells you that Medicare believes you no longer need skilled care and that you will be responsible for all costs from that point forward. You have the right to disagree and request an appeal, which pauses your financial responsibility while the appeal is reviewed.

The facility's social worker or discharge planner should help you understand this notice and explain your options. If you do not receive an ABN and Medicare straightforward stops paying, contact the facility when ready — this is a billing error.

The Difference Between Inpatient Rehabilitation and Outpatient Therapy

Inpatient rehabilitation (staying overnight in a skilled nursing facility) is covered under Medicare Part A and has the 100-day limit described above. Outpatient rehabilitation — physical therapy, occupational therapy, or speech therapy you receive at a clinic, hospital, or your home — is covered under Medicare Part B and has different rules.

Part B covers outpatient therapy with a yearly limit on the amount Medicare will pay, not on the number of visits. In 2024, that limit is $2,210 per therapy type (physical therapy and occupational therapy combined count as one limit; speech therapy is separate). Once you reach that dollar amount, you pay 20 percent of the cost for additional therapy, and Medicare pays nothing. Your therapist's office can tell you how much of your yearly limit you have used.

Some people move from inpatient SNF care to outpatient therapy at home or at a clinic. If this happens, your Part A coverage ends, but Part B coverage for outpatient therapy begins. These are separate benefit categories with separate limits.

What Happens When Your 100 Days End

If you reach day 100 and still need rehabilitation, Medicare will not pay for additional skilled nursing facility care. You have several options: you can pay out of pocket, you can move to a facility that accepts Medicaid (if you are may be able to access), or you can return home and pursue outpatient therapy covered under Part B.

Some people are discharged to home health care, which is covered under Part A if a doctor orders it and you meet the homebound requirement. Home health can include physical therapy, occupational therapy, and nursing care. This is different from skilled nursing facility care and has its own coverage rules, but it does not count against your 100-day limit.

Before you reach day 100, the facility's discharge planner should discuss these options with you and help you understand what will happen next. If the facility does not bring this up, ask directly: "What happens on day 101, and what are my options?"

How to Check Your Remaining Days and Coverage Status

You can see how many days you have used and how many remain by logging into your Medicare.gov account and viewing your claims. You can also call 1-800-MEDICARE and ask a representative to tell you your remaining days. The facility's billing department can also provide this information.

Keep track of your own count. Facilities sometimes make errors, and you want to know well before day 100 arrives whether Medicare is likely to stop paying early. If you notice that your progress notes do not reflect the improvements you feel you are making, talk to your therapist or doctor. Ask them to document specific gains — this becomes important if you need to appeal a coverage denial.

What to Do If Medicare Stops Paying Before Day 100

If you receive an Advance Beneficiary Notice saying Medicare will stop paying, you have three choices: accept the notice and agree to pay out of pocket, request an appeal, or ask the facility to continue care while your appeal is pending (you may owe the bill if you lose the appeal, but your financial responsibility is paused during review).

To appeal, you must act within a specific timeframe — usually within 120 days of receiving the notice. The appeal process has multiple levels. You start with a reconsideration by a different Medicare contractor, then move to an administrative law judge if you disagree with that decision. Many people hire a patient advocate or attorney to help with appeals, especially if the dollar amount is large.

Contact your State Health Insurance information Program (SHIP) for free help understanding your appeal rights. You can find your local SHIP by calling 1-800-MEDICARE or visiting shiptacenter.org.

Rehabilitation Coverage After a Hospital Readmission

If you are discharged from a skilled nursing facility, go home, and then return to the hospital within a short time, a new benefit period may begin. This means you could potentially receive another 100 days of skilled nursing facility coverage. However, Medicare has rules about what counts as a new benefit period, and they are strict.

Generally, you must be out of the hospital or skilled nursing facility for 60 consecutive days for a new benefit period to start. If you are readmitted before 60 days have passed, you are still in the same benefit period, and your remaining days are what you have left — not a fresh 100 days. This is a common source of confusion and financial hardship. Ask your hospital discharge planner to explain your benefit period status before you leave.

Frequently Asked Questions

Does Medicare cover rehabilitation at home instead of a nursing facility?

Yes, but only if a doctor orders it and you meet the homebound requirement — meaning you cannot leave home without help. Home health rehabilitation is covered under Part A and does not count against your 100-day skilled nursing facility limit. However, home health has its own may be able to access rules and coverage limits.

What if my doctor says I need more rehabilitation but Medicare says I can stop?

Your doctor's opinion matters, but Medicare makes the final decision about payment. If you disagree with Medicare's decision, you can appeal. During the appeal, you can ask the facility to continue your care while your case is reviewed, though you may owe the bill if you lose. An appeal does not may provide coverage will continue, but it gives you a chance to present evidence of your progress.

Do I have to pay the daily coinsurance on days 21 through 100?

Yes, unless you have a supplemental insurance plan (Medigap) or Medicaid that covers it. The coinsurance amount is set by Medicare each year. If you cannot afford it, ask the facility's financial counselor about payment plans or whether you might be may be able to access for Medicaid.

What if the facility discharges me but I still need care?

You have the right to appeal a discharge decision if you believe you still need skilled care. The facility must give you written notice before discharge, and you can request an appeal before you leave. If you are already home and believe the discharge was premature, you can still appeal within 120 days, though the process is more difficult.

Does my Medicare Advantage plan cover rehabilitation differently?

Medicare Advantage plans must cover at least what Original Medicare covers, but some plans offer additional days or lower out-of-pocket costs. Contact your plan directly to ask about your specific rehabilitation coverage limits and any prior authorization requirements.