Medicare Coverage for Physical Therapy: What's Included in 2026
Quick Answer
Yes. Medicare covers medically necessary physical therapy under Part B, and the annual dollar cap was eliminated in 2018. You typically pay 20% after the deductible.
Physical therapy is well covered by Medicare, and the old hard dollar cap is gone. There is still a documentation threshold, but it is not a limit on how much therapy you can receive when it is medically necessary.
What Original Medicare Covers for Physical Therapy
Part AHospital Coverage
- Physical therapy during a covered inpatient hospital or skilled nursing facility stay
- Home health physical therapy for homebound beneficiaries
Part BMedical Coverage
- Outpatient physical therapy that is medically necessary and ordered by a doctor
- Occupational therapy and speech-language pathology under the same rules
- Skilled maintenance therapy when a skilled professional is required
What Medicare Advantage May Add
Benefits vary by plan, county, and year. The items below are common but not guaranteed — always confirm in the plan’s Summary of Benefits.
- Different copay structures than Original Medicare
- Prior authorization is common — confirm before starting
- Some plans include extra rehab or wellness benefits
What Is NOT Covered
- Therapy that is not medically necessary
- Maintenance exercises you can safely do yourself without a skilled provider
- Services from providers not enrolled in Medicare
What You Can Expect to Pay
Outpatient PT
20% coinsurance after the Part B deductible ($257 in 2025)
Documentation threshold
Around $2,410 in 2025 — this triggers extra documentation, not a cap
In Your State
In Florida, Texas, Arizona, Georgia, North Carolina, and South Carolina, Medicare Advantage plans cover physical therapy but often apply prior-authorization and visit-review rules. Copays and approval processes vary by plan.
Tips to Maximize Your Physical Therapy Coverage
- 1There is no longer a dollar cap on medically necessary physical therapy.
- 2Get a doctor’s order and make sure your therapist is Medicare-enrolled.
- 3On Medicare Advantage, confirm prior-authorization requirements before starting.
- 4Ask about home health physical therapy after surgery if you are homebound.
- 5Skilled maintenance therapy can be covered — it is not automatically excluded.
Frequently Asked Questions
Does Medicare cover physical therapy?
Yes. Part B covers medically necessary outpatient physical therapy ordered by your doctor. You typically pay 20% of the Medicare-approved amount after meeting the deductible.
Is there a limit on physical therapy?
No hard dollar cap — that was repealed in 2018. There is a documentation threshold (about $2,410 in 2025) above which your provider must document that continued therapy is medically necessary.
Does Medicare cover physical therapy at home?
Yes. If you are homebound and need skilled care, Medicare covers home health physical therapy through a Medicare-certified home health agency.
How much does physical therapy cost with Medicare?
Under Part B you generally pay 20% of the Medicare-approved amount after the deductible. A Medigap policy or Medicare Advantage plan can change that cost-sharing.
Find a Plan That Covers Your Physical Therapy Care
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See all conditions and services Medicare coversThis information is for educational purposes. Consult your doctor for medical advice and a licensed Medicare advisor for plan coverage questions. Plan availability, benefits, and costs vary by ZIP code and change annually; dollar amounts are shown with the year they apply and update each year.
HealthPlan Connect is not affiliated with or endorsed by the federal Medicare program or any government agency. We do not offer every plan available in your area. Last reviewed 2026-06-10 by Lynsey Brennan, Licensed Medicare Advisor (FL License #G007269).