Medicare & Physical Therapy: A Comprehensive Guide for Recipients

Medicare Part B Coverage for Physical Therapy

Medicare Part B covers physical therapy services that are medically necessary for the treatment of injuries, illnesses, or disabilities. These services include:

• Evaluation of the patient's condition
• Development of a treatment plan
• Provision of physical therapy treatments
• Education on how to manage the patient's condition

What Conditions Qualify for Medicare Coverage?

Medicare covers physical therapy for a wide range of conditions, including:

• Arthritis
• Back pain
• Hip pain
• Knee pain
• Neck pain
• Osteoporosis
• Parkinson's disease
• Sports injuries

How to Access Physical Therapy Services

To access physical therapy services under Medicare, you will need to:

1. Get a referral from your doctor. Your doctor will need to determine that you have a qualifying condition and that physical therapy is medically necessary for your treatment.
2. Find a Medicare-participating physical therapist. You can find a Medicare-participating physical therapist by visiting the Medicare website or calling 1-800-MEDICARE (1-800-633-4227).
3. Schedule an appointment. Once you have found a Medicare-participating physical therapist, you can schedule an appointment for an evaluation.

What to Expect at Your First Appointment

Your first appointment with a physical therapist will typically include:

• A review of your medical history
• A physical examination
• A discussion of your goals for physical therapy
• The development of a treatment plan

How Much Does Medicare Cover?

Medicare Part B covers 80% of the approved amount for physical therapy services. The remaining 20% is your responsibility. You may be able to use your Medigap plan to cover the remaining costs.

Table 1: Medicare Part B Coverage for Physical Therapy Services

Tips for Getting the Most from Your Medicare Physical Therapy Coverage

• Make sure your doctor refers you to a Medicare-participating physical therapist. This will ensure that your services are covered by Medicare.
• Be prepared to pay for a small portion of your physical therapy services. You will need to pay for the remaining 20% of the cost of your services that Medicare does not cover.
• Consider using a Medigap plan. A Medigap plan can help you cover the remaining costs of your physical therapy services.
• Be active in your physical therapy. The more you participate in your physical therapy, the greater the benefits will be.
• Communicate with your physical therapist. Let your physical therapist know how you are feeling and if you are experiencing any problems.

Conclusion

Medicare can be a valuable resource for people who need physical therapy. By understanding how Medicare covers physical therapy, you can make the most of your benefits and improve your health.

Additional Resources

• Medicare Coverage for Physical Therapy
• Physical Therapy