Does medicare cover costs of physical therapy sessions?
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DOES MEDICARE ADVANTAGE COVER PHYSICAL THERAPY? Private Medicare Advantage plans must cover the same services as original Medicare, but often have different out-of-pocket costs and
conditions. For example, you may have a $10 to $40 copayment for physical or occupational therapy visits, need to use an in-network provider and receive prior authorization from the plan
before therapy is covered. You can check out physical therapy coverage for Medicare Advantage plans in your area by using the Medicare Plan Finder. Find a list of plans available in your zip
code, click PLAN DETAILS | BENEFITS AND COSTS and scroll down to therapy services to see copayments for physical, occupational, speech and language therapy. Click PLAN WEBSITE under the
plan’s name and search for the plan’s Summary of Benefits for more information. KEEP IN MIND Medicare eliminated its annual maximum payment for outpatient therapeutic services cap in 2018.
While the program no longer limits what it will pay yearly for therapy services, if your annual therapy costs reach a certain threshold, your provider must confirm that the therapy is
medically necessary. In 2024, that amount is $2,330 for physical therapy and speech language pathology combined, and $2,330 for occupational therapy. Return to Medicare Q&A main page