Medicare covers in-home physical therapy, but only when a doctor orders it as part of treatment for an injury, illness, or surgery — not for general wellness or fitness.

Medicare Part B pays for physical therapy in your home if you meet three conditions: a doctor must order it, you must be homebound or have a medical reason you cannot leave home safely, and the therapy must be medically necessary to treat a specific condition. The therapist must be employed by or contracted with a Medicare-approved home health agency, not working independently.

You typically pay 20 percent of the Medicare-approved amount after you meet your Part B deductible. The home health agency bills Medicare directly, so you do not pay upfront and then seek reimbursement. The number of visits Medicare covers depends on your condition and what your doctor prescribes — there is no set limit, but the agency must document medical necessity for each visit.

Key Takeaways

  • A doctor must order in-home physical therapy as treatment for a specific medical condition, not for general fitness or prevention.
  • You must be homebound or unable to leave home safely due to your medical condition for Medicare to cover home-based therapy.
  • The physical therapist must work for or through a Medicare-approved home health agency; independent therapists are not covered.
  • You pay 20 percent of the Medicare-approved cost after meeting your Part B deductible; the agency bills Medicare directly.
  • Your doctor's order must specify the type and frequency of therapy, and the home health agency must justify each visit to Medicare.

When Medicare Covers In-Home Physical Therapy

Medicare Part B covers in-home physical therapy when you are recovering from surgery, managing a chronic illness, or treating an injury that limits your ability to move safely. Common reasons include recovery after hip or knee replacement, stroke rehabilitation, arthritis management, and regaining strength after hospitalization. The therapy must address a medical problem, not general fitness or wellness.

The homebound requirement is central to Medicare's coverage. You are considered homebound if leaving home requires considerable and taxing effort due to your medical condition, or if your doctor says you should not leave home. This does not mean you never leave — it means leaving is medically risky or exhausting. If you can safely go to an outpatient clinic, Medicare will not cover home-based therapy instead.

Your doctor must write an order that names the specific condition being treated, the type of therapy needed (physical therapy, occupational therapy, or speech therapy), and how often you should receive it. Medicare reviews this order before approving coverage. If your condition improves and you no longer need therapy, or if you become able to travel to a clinic, coverage ends.

How to Start In-Home Physical Therapy Through Medicare

Begin by talking to your doctor about whether in-home physical therapy would help your condition. If your doctor agrees, they will write an order and send it to a Medicare-approved home health agency. You can ask your doctor which agencies they work with, or you can search for agencies in your area on Medicare.gov by using the "Care Compare" tool under the "Home Health Agencies" section.

Once your doctor's order reaches the agency, a nurse or therapist will contact you to schedule an initial assessment visit. During this visit, the agency gathers information about your home, your medical history, and what you hope to achieve. The therapist then creates a treatment plan and begins therapy visits. The agency handles all billing to Medicare — you do not submit claims yourself.

If you have a Medigap or Medicare Advantage plan in addition to Original Medicare, your supplemental coverage may affect your out-of-pocket costs. Check your plan documents or call your plan's customer service line to understand what you will owe.

What You Pay for In-Home Physical Therapy

Under Original Medicare Part B, you pay 20 percent of the Medicare-approved amount for each therapy visit, after you have met your annual Part B deductible. The deductible amount changes each year; for 2024, it is $240. Once you reach that deductible, you pay 20 percent of approved costs for the rest of the calendar year.

The actual cost varies by region and by the specific services provided. Medicare sets the approved amount, and the home health agency must accept that amount as payment in full — they cannot bill you for the difference between their fee and what Medicare pays. If the agency charges you more than 20 percent of the approved amount, report it to Medicare by calling 1-800-MEDICARE.

If you have a Medicare Advantage plan, your costs may be different. Some plans cover in-home therapy with a copay per visit; others cover it at no cost. Contact your plan directly to learn your out-of-pocket responsibility before therapy begins.

Finding and Choosing a Medicare-Approved Home Health Agency

Not all home health agencies accept Medicare. Your agency must be Medicare-certified, which means it has met federal standards for staffing, training, and safety. You can search for certified agencies near you on Medicare.gov's Care Compare tool. The tool shows each agency's name, address, phone number, and performance ratings based on patient surveys and quality measures.

You have the right to choose which Medicare-approved agency provides your care. If your doctor recommends one, you can use that agency, or you can select a different one. Some agencies are larger and serve many areas; others are smaller and local. Ask about their experience treating your specific condition and how quickly they can schedule your first visit.

Before starting, confirm that the agency is in-network with your insurance plan if you have a Medicare Advantage plan. Out-of-network agencies may charge you more or may not be covered at all under your plan.

What Happens If Your Condition Changes

If you improve and no longer need therapy, your doctor or the home health agency will end your services. Medicare does not require you to continue therapy if you have reached your goals or if your condition no longer warrants it. You can also stop therapy at any time by telling the agency in writing.

If your condition worsens or you develop a new problem that needs therapy, your doctor can write a new order. The home health agency can restart services or adjust your treatment plan. There is no limit to how many times you can receive in-home therapy during your lifetime, as long as each course of treatment is medically necessary and ordered by your doctor.

If you move to a nursing home or assisted living facility, Medicare coverage for in-home therapy ends because you are no longer living in your own home. However, the facility may provide therapy as part of your care, depending on your situation and the type of facility.

Frequently Asked Questions

Can I choose my own physical therapist instead of using the home health agency's therapist?

No. Medicare only covers therapy provided by a therapist employed by or contracted with a Medicare-approved home health agency. Independent physical therapists are not covered under this benefit, even if they visit your home. Your agency assigns a therapist based on availability and your needs.

Does Medicare cover in-home physical therapy for arthritis or general pain management?

Medicare covers therapy for arthritis only if it is part of treatment for a specific medical event — such as recovery after joint replacement surgery or regaining function after a fall. General pain management or fitness for arthritis alone is not covered. Talk to your doctor about whether your situation qualifies.

What if I do not have a regular doctor to order the therapy?

You will need to see a doctor — your primary care physician, a specialist, or even a doctor at an urgent care clinic — who can evaluate your condition and write an order for therapy. Medicare requires a physician's order; nurse practitioners and physician assistants can also write orders in some states. Contact a home health agency to ask which types of providers they accept orders from.

How long does it take for Medicare to approve in-home physical therapy?

Once the home health agency receives your doctor's order, they typically begin the approval process within one to two business days. Most approvals come through within a week, though complex cases may take longer. The agency will contact you with a start date once Medicare approves coverage.

Can I receive in-home physical therapy if I have a Medicare Advantage plan?

Yes, but coverage rules and costs vary by plan. Some Medicare Advantage plans cover in-home therapy with a copay; others cover it fully. Contact your plan before starting therapy to understand your costs and to confirm the agency is in-network with your plan.