Medicare covers up to 100 days of inpatient rehabilitation per benefit period, but you pay nothing for days 1–20 and a daily copay for days 21–100

Medicare Part A covers inpatient rehabilitation facility (IRF) stays after a hospital admission of at least three days. The coverage runs for a full benefit period — which resets 60 days after you leave the hospital — and maxes out at 100 days total. You pay nothing for the first 20 days. From day 21 onward, you owe a copay equal to one-quarter of the hospital deductible for that year, which changes annually.

The catch is that Medicare must determine your stay is medically necessary. A doctor at the rehabilitation facility reviews your case within a few days of arrival. If Medicare's medical reviewers decide you no longer need daily skilled nursing or therapy, they can end coverage even if you have days remaining. This happens more often than many people expect, and it is the main reason people end up paying out of pocket for rehabilitation.

Outpatient rehabilitation — therapy you receive at a clinic or at home without an overnight stay — follows different rules and has no day limit, though Medicare does cap what it will pay per service.

Key Takeaways

  • Medicare Part A covers up to 100 days in an inpatient rehabilitation facility per benefit period if you spent at least three days in a hospital first.
  • You pay nothing for days 1–20; from day 21 onward you owe a daily copay (one-quarter of the annual hospital deductible, currently around $97 per day in 2024).
  • A Medicare medical reviewer can end your coverage before day 100 if they determine you no longer need inpatient-level care, even if your doctor disagrees.
  • Outpatient rehabilitation has no day limit but is subject to different payment rules and may require a referral from your doctor.

What counts as a may have access to hospital stay

To use your Medicare rehabilitation benefit, you must first spend three consecutive days in a hospital as an inpatient. The three days must be for the same condition or a related one — a day for a heart attack followed by two days for something unrelated does not count. The day you are discharged does not count toward the three days.

Once you have met the three-day requirement, you can move to an inpatient rehabilitation facility. Medicare will cover the stay if your doctor orders it and the facility accepts Medicare. You do not have to go to the facility when ready after leaving the hospital, but the longer you wait, the more likely Medicare will question whether the stay is still medically necessary for the original condition.

How the 100-day limit works across benefit periods

Your 100 days reset when you start a new benefit period. A benefit period begins the day you enter a hospital and ends 60 days after you are discharged. If you are readmitted to a hospital more than 60 days after your last discharge, a new benefit period starts, and you get another 100 days of rehabilitation coverage.

If you are discharged from rehabilitation before using all 100 days and then readmitted within the same benefit period, your remaining days carry over. For example, if you use 30 days in your first stay and are readmitted 40 days after discharge (still within the same benefit period), you have 70 days left. If you are readmitted 65 days after discharge, a new benefit period has started and you have 100 days again.

What you pay: copays and deductibles

Days 1–20 of inpatient rehabilitation cost you nothing beyond what you have already paid toward your hospital deductible. Starting on day 21, you owe a daily copay. In 2024, this copay is $97 per day, but it changes each year along with the hospital deductible. Check your Medicare Summary Notice or call Medicare at 1-800-MEDICARE to confirm the current year's amount.

If you have a Medigap or Medicare Advantage plan, your supplemental coverage may pay some or all of this copay. Check your plan documents or call your plan's customer service line to find out what your out-of-pocket cost will be.

When Medicare stops paying before day 100

Medicare does not automatically pay for all 100 days. A utilization review nurse employed by Medicare (or by a contractor working on Medicare's behalf) will examine your medical record within a few days of admission. They assess whether you need daily skilled nursing care or intensive rehabilitation therapy that cannot be provided in an outpatient setting.

If the reviewer decides you do not meet this standard, Medicare can issue a notice that coverage will end on a specific date — often much sooner than day 100. You then have the right to appeal, but you must do so within 120 days of receiving the notice. If you disagree with the decision, you can request a peer-to-peer review, where your doctor speaks directly with a Medicare medical reviewer. Many appeals succeed, but not all.

If you do not appeal and stay past the date Medicare says coverage ends, you become responsible for the full cost of the facility. This can run $300–$500 per day or more, depending on the facility and your location.

Outpatient rehabilitation coverage and limits

If you receive therapy at a clinic, your home, or a hospital outpatient department, Medicare Part B covers it under different rules. There is no day limit, but Medicare does cap the amount it will pay per year for physical therapy and occupational therapy combined, and a separate cap for speech-language pathology. These caps change yearly; in 2024 they are $2,430 per category, though some exceptions allow higher spending.

Your doctor must order the therapy and state that it is medically necessary. The facility must be Medicare-certified. You typically pay 20 percent of the approved cost after you have met your Part B deductible (currently $240 in 2024). If you have a Medigap plan, it may cover this 20 percent coinsurance.

How to find a Medicare-approved rehabilitation facility

Your hospital discharge planner will usually suggest facilities, but you have the right to choose any Medicare-certified inpatient rehabilitation facility. To verify that a facility accepts Medicare, call it directly and ask, or search the Medicare Care Compare tool at care.cms.gov. You can also call 1-800-MEDICARE and ask for a list of facilities in your area.

Before admission, ask the facility about its appeal process and whether it has a patient advocate on staff. Ask your doctor to write clear notes about why inpatient rehabilitation is necessary — this helps if a utilization review later questions the stay. If possible, get the facility's discharge planner's contact information before you leave the hospital so you can coordinate your transfer.

Frequently Asked Questions

Can I use my 100 days across multiple facilities?

Yes. If you move from one inpatient rehabilitation facility to another within the same benefit period, your days carry over. You still have 100 days total, not 100 per facility. Make sure the new facility is Medicare-certified and that your doctor orders the transfer.

What happens if I leave rehabilitation early?

If you leave against medical information or are discharged early because you no longer need inpatient care, you stop using your days. If you are readmitted within the same benefit period, you have your remaining days available. If a new benefit period has started, you get 100 days again.

Does Medicare cover rehabilitation at home?

Home health services, including therapy at home, are covered by Medicare Part A if you are homebound and a doctor orders them. This is different from inpatient rehabilitation and does not count against your 100-day limit. You pay nothing if you have met your Part A deductible.

What if I have a Medicare Advantage plan instead of Original Medicare?

Medicare Advantage plans must cover at least the same 100 days of inpatient rehabilitation that Original Medicare does, but some plans offer more. Check your plan's coverage documents or call customer service to learn your specific limits and copays.

Can I appeal if Medicare denies my rehabilitation stay?

Yes. You have 120 days from the date you receive the denial notice to file an appeal. Request a peer-to-peer review if possible, where your doctor speaks with a Medicare medical reviewer. Many denials are overturned on appeal, especially if your medical condition has changed or worsened.