Yes, Medicare covers physical therapy. Under Original Medicare, Part B pays 80% of approved charges for outpatient physical therapy after you meet your annual deductible, which is $257 in 2025. You’re responsible for the remaining 20% coinsurance. Coverage applies whether you receive therapy in a clinic, a hospital outpatient department, or at home, as long as the services are medically necessary and ordered by a physician or qualified provider.
What “Medically Necessary” Means for Coverage
Medicare doesn’t cover physical therapy simply because a doctor orders it. The services must require the skill and expertise of a licensed therapist, not just exercises you could do on your own after being shown how. The key question Medicare asks: does your condition require a trained clinician’s hands-on involvement, or could a non-skilled person carry out the same activities?
Your diagnosis alone doesn’t determine coverage. Someone with severe arthritis might qualify for skilled therapy to restore range of motion, while someone else with the same diagnosis might not if their needs can be met through a basic home exercise program. Your therapist’s documentation needs to show why their clinical expertise is necessary for your specific situation.
Outpatient Therapy Under Part B
Most people use physical therapy on an outpatient basis, visiting a clinic or therapist’s office a few times per week. Part B covers these visits at the standard 80/20 split after your deductible. You can see any Medicare-enrolled physical therapist without a referral in most cases, though your doctor or another qualified provider must certify your plan of care.
A plan of care must be established before treatment begins, and your physician needs to sign off on it within 30 days of your first session. Every 90 days, the plan requires recertification to continue coverage. Starting in 2025, an exception allows therapists to begin treatment based on a written referral from your doctor, then transmit the treatment plan for approval within 30 days, rather than waiting for a signature upfront.
The Therapy Spending Threshold
Medicare doesn’t impose a hard annual cap on physical therapy, but there is a spending threshold that triggers extra scrutiny. For 2026, that threshold is $2,480 for physical therapy and speech therapy services combined. Once your approved charges cross that line, your therapist must add a special billing code (called a KX modifier) confirming that continued treatment is medically necessary. Without it, claims are automatically denied.
This doesn’t mean you’re cut off at $2,480. It means your therapist needs to document a clear clinical justification for every session beyond that point. If you’re recovering from a major surgery or a complex injury, exceeding the threshold is common and typically approved as long as the paperwork supports it.
Physical Therapy in a Skilled Nursing Facility
If you need physical therapy after a hospital stay, Medicare Part A covers it in a skilled nursing facility under specific conditions. You must first have a qualifying inpatient hospital stay of at least three consecutive days (not counting the discharge day). The stay must be medically necessary, not just for observation.
Part A covers up to 100 days per benefit period in a skilled nursing facility:
- Days 1 through 20: You pay nothing after meeting the $1,736 deductible for 2026.
- Days 21 through 100: You pay $217 per day in 2026.
- After day 100: You pay all costs yourself.
Physical therapy is one of the skilled services that qualifies you for this coverage. Many people don’t need the full 100 days, but it’s there if your recovery requires it.
Home-Based Physical Therapy
If you’re homebound, Medicare covers physical therapy delivered in your home through the home health benefit. “Homebound” means leaving your home requires considerable effort because of illness or injury, whether that involves needing a wheelchair, special transportation, or help from another person. It can also mean your doctor has advised against leaving home because of your condition.
A healthcare provider must assess you face-to-face before certifying your need for home health services, and the care must be provided by a Medicare-certified home health agency. The physical therapy itself must be part-time or intermittent. If you need full-time skilled care, you won’t qualify for this benefit, though you may qualify for inpatient rehabilitation instead.
Maintenance Therapy Coverage
A common misconception is that Medicare only covers physical therapy when you’re actively improving. Medicare also covers what’s called a maintenance program, where a therapist designs a plan to help you keep the functional gains you’ve made, prevent decline, or ensure your safety at home. The therapist can also train you or a caregiver to carry out the maintenance exercises independently.
The catch is that once the maintenance program is established and you or your caregiver can perform the activities without a therapist’s supervision, Medicare stops covering the ongoing sessions. Coverage resumes if your condition changes and the program needs updating by a skilled clinician. If you later need a new round of therapy for the same condition, your therapist will conduct a full re-evaluation and document why skilled care is necessary again.
How Medicare Advantage Plans Differ
If you have a Medicare Advantage plan (Part C) instead of Original Medicare, physical therapy is still covered because these plans must offer at least the same benefits as Parts A and B. However, the rules around accessing that coverage can be quite different.
Medicare Advantage plans often require prior authorization before you start physical therapy, meaning your plan must approve the treatment before your first visit. Original Medicare almost never requires prior authorization. Advantage plans also typically restrict you to in-network providers, and your out-of-pocket costs, visit limits, and copay amounts vary by plan. Check your plan’s specific requirements before scheduling therapy to avoid unexpected denials or bills.
Telehealth Physical Therapy
Medicare currently covers physical therapy delivered via telehealth, including video visits and even audio-only phone calls. These flexibilities, originally expanded during the pandemic, have been extended through December 31, 2027. There are no geographic restrictions, and you can receive telehealth therapy sessions from your home regardless of where you live. Whether these flexibilities will be renewed beyond 2027 remains uncertain, so this is worth keeping an eye on if telehealth is your preferred option.