Medicare Part B covers a specific set of medical services for nursing home residents, but it does not cover the nursing home stay itself. Room, board, and daily personal care fall outside Part B’s scope. What Part B does pay for are outpatient-style medical services you receive while living in a nursing home: doctor visits, therapy, preventive screenings, mental health care, and medically necessary ambulance transportation. Understanding this distinction matters because most nursing home care is custodial, and Medicare explicitly excludes custodial care from coverage.
Why Part B Matters in a Nursing Home
Most people associate nursing home coverage with Medicare Part A, which pays for up to 100 days of skilled nursing facility care after a qualifying hospital stay. But Part A is temporary. Once that 100-day benefit runs out, or if you never qualified for a skilled nursing stay in the first place, Part B becomes the primary way Medicare helps pay for your medical needs in a nursing home.
Part B functions the same way in a nursing home as it does in the community. It covers medically necessary outpatient services regardless of where you live. The key limitation: it will not pay for your room, meals, or help with daily activities like bathing, dressing, eating, or using the bathroom. Medicare classifies all of that as custodial care, and in most cases, custodial care is not covered if it’s the only care you need.
Doctor Visits and Medical Services
Part B covers visits from physicians, nurse practitioners, clinical nurse specialists, and physician assistants who come to the nursing home to treat you. These visits work the same as an office appointment. Your provider bills Medicare, and after you meet the annual Part B deductible ($257 in 2025), you pay 20% of the Medicare-approved amount for each service. Routine check-ups, treatment of new symptoms, medication management, and follow-up care for chronic conditions all fall under this umbrella.
Physical, Occupational, and Speech Therapy
Therapy services are one of the most important Part B benefits for nursing home residents. Part B covers physical therapy, occupational therapy, and speech-language pathology when a doctor or qualified provider certifies that the services are medically necessary. This applies whether the goal is to restore function after an injury, maintain your current abilities, or slow a decline.
There is no annual dollar cap on how much Medicare will pay for medically necessary outpatient therapy in a calendar year. You pay 20% of the approved amount after meeting the Part B deductible. The therapy must be ordered by your provider, and the nursing home typically arranges for therapists to see you on-site.
Preventive Screenings and Vaccines
Living in a nursing home doesn’t disqualify you from the full range of Part B preventive services, and most of them cost you nothing if your provider accepts Medicare assignment. The list is extensive:
- Vaccines: flu shots, pneumococcal shots, COVID-19 vaccines, and hepatitis B shots
- Cancer screenings: mammograms, colonoscopies, lung cancer screenings, prostate cancer screenings, and cervical cancer screenings
- Chronic disease screenings: diabetes screenings, cardiovascular disease screenings, glaucoma tests, and bone density measurements
- Mental health screenings: depression screenings and alcohol misuse screenings with counseling
- Other services: hepatitis B and C screenings, HIV screenings, obesity behavioral therapy, medical nutrition therapy, and tobacco cessation counseling
Nursing home residents are also entitled to an annual wellness visit, during which a provider reviews your health, updates your prevention plan, and screens for cognitive changes. If you’re new to Medicare, the one-time “Welcome to Medicare” preventive visit is covered as well.
Mental Health and Psychiatric Services
Part B covers psychiatric and psychological services for nursing home residents, including initial evaluations, individual psychotherapy, group therapy, and medication management by a psychiatrist. These services must be reasonable and necessary for diagnosing or treating a mental health condition.
To qualify for ongoing psychiatric care, the nursing home’s records need to support the clinical need. Each resident undergoes periodic assessments that document cognitive patterns, mood, behavior, and psychosocial well-being. Those assessments serve as the foundation for justifying continued mental health treatment under Part B. Your provider also needs to document that you have the capacity to participate in and benefit from the therapy being provided.
Durable Medical Equipment
Part B covers durable medical equipment (wheelchairs, walkers, hospital beds, oxygen equipment, and similar items) when a doctor orders it and it meets Medicare’s definition: the equipment must be durable, medically necessary, useful primarily for someone who is sick or injured, and intended for use in your home. Medicare considers a nursing home your home for this purpose if you are a long-term resident rather than receiving a short-term skilled nursing stay under Part A.
The standard cost-sharing applies. After the deductible, you pay 20% of the Medicare-approved amount. The equipment must be ordered through a Medicare-enrolled supplier.
Ambulance Transportation
If you need to leave the nursing home for emergency care or a specialist visit that can’t be provided on-site, Part B covers ambulance transportation under specific conditions. Ground ambulance is covered when traveling in any other vehicle would endanger your health, and Medicare will only pay for transport to the nearest facility capable of providing the care you need.
Non-emergency ambulance trips can also be covered if your doctor writes an order stating the transportation is medically necessary. For example, if you need dialysis at an outside facility and cannot safely travel by car, Part B may cover the ambulance. In rare situations involving remote locations or time-sensitive emergencies, Medicare may pay for air ambulance transport. After the deductible, you pay 20% of the approved amount.
What Part B Does Not Cover
The most significant gap is custodial care. If your daily needs in a nursing home consist primarily of help with bathing, dressing, eating, toileting, and transferring in and out of bed, Medicare Part B will not pay for any of that. It also will not cover your room or meals. These costs typically fall on Medicaid (for those who qualify), long-term care insurance, or out-of-pocket payment.
Part B also does not cover services that aren’t medically necessary. Therapy provided without a doctor’s order, equipment that doesn’t meet Medicare’s durability and medical-need criteria, or psychiatric sessions without supporting documentation in your care plan would all be denied. Every Part B service in a nursing home must be tied to a specific medical need and properly ordered by a qualified provider.