Medicare covers physical therapy, but only under specific conditions and in certain settings
Medicare Part B pays for physical therapy when a doctor orders it to treat a medical condition — not for general fitness or wellness. The therapy must be medically necessary, meaning it addresses an injury, illness, or loss of function that a healthcare provider has documented. You will pay a copay for each visit after you meet your Part B deductible, and there are limits on how many visits Medicare will fund in a calendar year.
The setting matters. Medicare covers physical therapy in outpatient clinics, hospitals, skilled nursing facilities, and your home (if you are homebound). It does not cover therapy at a gym, fitness center, or wellness facility, even if a therapist works there. The therapist must be licensed and the facility must be Medicare-certified.
Key Takeaways
- Your doctor must order physical therapy and document that it treats a specific medical condition, not general fitness or prevention.
- You pay 20 percent of the Medicare-approved amount for each visit after you meet your Part B deductible, which is $240 in 2024.
- Medicare limits combined physical therapy and occupational therapy visits to 60 per year, though you can request more if medically necessary.
- Therapy in a hospital outpatient department, skilled nursing facility, or your home is covered; therapy at a gym or wellness center is not.
- If your doctor refers you to an out-of-network therapist, Medicare will not pay, so confirm the facility accepts Medicare before your first visit.
How much you pay for each physical therapy visit
After you meet your Part B deductible ($240 in 2024), you pay 20 percent of what Medicare approves for the visit. The actual amount depends on the type of therapy, the facility, and your location. A typical copay ranges from $30 to $60 per session, but can be higher in some areas or for complex treatments.
If the therapist or facility does not accept Medicare assignment — meaning they do not agree to charge only what Medicare approves — you may owe more. Always ask the facility before your first appointment whether they accept Medicare assignment and what your out-of-pocket cost will be.
If you have a Medigap or Medicare Advantage plan, your copay may be lower or covered entirely. Check your plan documents or call your plan to confirm what physical therapy costs you.
The annual visit limit and how to request more
Medicare combines physical therapy and occupational therapy into one 60-visit annual limit. This means if you use 40 physical therapy visits, you have 20 left for occupational therapy in the same calendar year. The limit resets on January 1.
If your doctor believes you need more than 60 visits, they can request an exception. Medicare calls this a manual review. Your doctor submits documentation showing why additional visits are medically necessary — for example, slow progress due to a complex injury or a condition that requires longer recovery. Medicare reviews the request and decides within a few business days. You will not know the outcome until Medicare notifies your doctor and the therapy facility.
Do not stop therapy while waiting for an exception decision. Continue your visits; if Medicare approves the exception, it covers the visits you had during the review period.
When your doctor must order therapy and what happens next
Your primary care doctor or a specialist can order physical therapy. The order must state the diagnosis, the type of therapy needed, and the expected duration. You do not need a separate referral for each visit — the initial order covers ongoing treatment at that facility.
Once you have an order, contact a Medicare-certified facility near you. Ask whether they accept Medicare and whether they have openings. The facility will verify your Medicare coverage and confirm your copay amount. At your first visit, bring your Medicare card and photo ID.
The therapist will perform an initial evaluation, which Medicare covers as a single visit. After that, you pay the standard copay for each treatment session. The therapist will also track your progress and report back to your doctor.
Physical therapy in different settings and what each covers
Medicare covers physical therapy in four main settings, and the rules differ slightly for each:
| Setting | Coverage Details | Your Copay |
|---|---|---|
| Outpatient clinic or private practice | Therapy at a freestanding facility or clinic. Facility must be Medicare-certified. Counts toward your 60-visit annual limit. | 20% of approved amount after deductible |
| Hospital outpatient department | Therapy at a hospital's outpatient facility. Usually higher facility fees than private clinics. Counts toward your 60-visit annual limit. | 20% of approved amount after deductible, plus possible facility copay |
| Skilled nursing facility (SNF) | Therapy during a covered stay after hospitalization. Included in your daily copay ($0 to $200 depending on day of stay). Does not count toward your 60-visit limit. | Included in SNF daily copay |
| Home health | Therapy at your home if you are homebound or cannot leave without help. Requires a doctor's order and homebound certification. Does not count toward your 60-visit limit. | $0 copay; covered under Part A or Part B depending on your situation |
If you are in a skilled nursing facility or receiving home health care, physical therapy is often included as part of that service and does not reduce your 60-visit outpatient limit. This is an important distinction if you are recovering from surgery or a serious illness.
What Medicare does not cover for physical therapy
Medicare does not pay for physical therapy ordered for general fitness, wellness, or prevention — even if a doctor recommends it for your overall health. Therapy must treat a specific medical condition: a fracture, stroke, arthritis, post-surgical recovery, or similar diagnosis.
Therapy at a gym, fitness center, or wellness facility is not covered, even if a licensed therapist works there. Therapy that is purely recreational or educational (such as a class on posture or exercise) is also not covered.
If your doctor refers you to a therapist who does not accept Medicare, Medicare will not pay. You would owe the full cost. Before your first visit, always confirm that the facility accepts Medicare.
How to find a Medicare-certified physical therapy facility
Start by asking your doctor for a referral to a specific facility or therapist. Your doctor may have a preferred network or know which facilities are nearby and accept Medicare.
You can also search the Medicare Provider Search tool on Medicare.gov. Enter your zip code and select "Physical Therapist" or "Physical Therapy Clinic." The tool shows certified facilities, their addresses, and phone numbers. Call ahead to confirm they are currently accepting new patients and to ask about your copay.
If you use a Medicare Advantage plan, check your plan's provider directory first. Some plans have a smaller network of in-network therapists, and using an out-of-network provider may cost you more or not be covered at all.
Frequently Asked Questions
Can I go to physical therapy without a doctor's order?
No. Medicare requires a doctor's order for physical therapy to be covered. Some states allow physical therapists to evaluate you without a referral, but Medicare will not pay for those visits. You must have a physician's order before treatment begins.
What if I run out of visits before the end of the year?
You can request a manual review if your doctor believes more visits are medically necessary. Your doctor submits documentation to Medicare explaining why. If approved, you can continue therapy. If denied, you can pay out of pocket or stop treatment.
Does Medicare cover telehealth physical therapy?
Medicare covers some telehealth physical therapy, but not all. Your doctor and therapist must determine whether your condition can be safely treated remotely. Not all facilities offer telehealth, so ask when you call to schedule.
Will my Medicare Advantage plan cover the same physical therapy as Original Medicare?
Medicare Advantage plans must cover at least what Original Medicare covers, but they may have different copays, deductibles, or visit limits. Check your plan documents or call your plan to confirm your specific coverage before starting therapy.
What happens if the therapist bills me instead of Medicare?
If a facility does not accept Medicare assignment, they can bill you for the full amount. Before your first visit, ask in writing whether the facility accepts Medicare assignment. If they do not, you can choose a different facility or pay out of pocket.