Short answer: Medicare Part B covers medically necessary outpatient physical therapy. There is no annual dollar limit on Medicare payment for medically necessary outpatient therapy.
Original Medicare coverage
Medicare covers physical therapy used to restore or improve movement after illness, injury, or surgery. It may also cover therapy used to maintain current function or slow decline when skilled therapy is medically necessary.
Outpatient therapy can be provided in a therapist’s office, hospital outpatient department, rehabilitation agency, skilled nursing facility for an outpatient, or other Medicare-approved setting. Physical therapy may also be covered through the home health benefit when the person meets the home health requirements.
Eligibility and limits
A doctor or other qualified provider, including a nurse practitioner, clinical nurse specialist, or physician assistant, must certify the need for therapy. The plan of care and records must support medical necessity. Medicare can review therapy after spending reaches a yearly threshold, but that threshold is not a fixed coverage cap. Services may continue when they remain reasonable, necessary, and properly documented.
For home health physical therapy, the person must qualify for the Medicare home health benefit and use a Medicare-certified home health agency. Medicare does not require improvement when skilled therapy is needed to maintain function or prevent or slow deterioration.
Costs
After the Part B deductible, the beneficiary generally pays 20 percent of the Medicare-approved amount. Hospital outpatient therapy may include facility charges. Qualifying home health services are generally covered without a copayment, although covered DME used at home has its own Part B cost sharing.
Medicare Advantage
Medicare Advantage plans cover medically necessary physical therapy but may require network therapists, referrals, prior authorization, or periodic review. Copayments and visit administration vary by plan.
What to do next
- Ask who will certify and update the plan of care.
- Confirm that the therapist and facility participate in Medicare.
- Ask whether hospital facility charges apply.
- For home therapy, confirm that the agency is Medicare certified.
Sources
- Medicare.gov: Physical therapy services
- Medicare.gov: Home health services
- Medicare.gov: Doctor and provider services
Last reviewed: August 2026. Medicare rules and plan benefits can change.