How Much Does Medicare Pay For Physical Therapy Per Visit?

In this article we are going to talk about How Much Medicare Pay For Physical Therapy Per Visit, Physical therapy is a type of health care service that helps people recover from injuries, illnesses, or chronic conditions that affect their ability to function.

Physical therapy can improve mobility, strength, balance, coordination, and quality of life.

But how much does Medicare, the federal health insurance program for older adults and people with disabilities, pay for physical therapy per visit?

This is a common question that many Medicare beneficiaries and their caregivers may have, especially if they need frequent or long-term physical therapy services.

An infographic of Medicare Pay for Physical Therapy Per visit
Medicare Pay for Physical Therapy Per visit

Medicare Physical Therapy Copay

The Medicare copayment for physical therapy refers to the portion you’re responsible for paying out-of-pocket for covered services.

Under Original Medicare, after meeting your Part B deductible (set at $240 in 2024), you typically pay a 20% coinsurance for outpatient physical therapy.

There’s no annual cap on Medicare’s coverage for medically necessary outpatient therapy.

Still, your provider may need to confirm its necessity if your therapy costs exceed certain thresholds within a year ($2,230 for physical therapy and speech-language pathology combined, and $2,230 for occupational therapy in 2023).

For inpatient physical therapy received in settings like hospitals or skilled nursing facilities, copayments vary depending on factors like facility type, length of stay, and Part A deductible and coinsurance.

For instance, in 2024, you might pay $1,556 per benefit period for days 1-60 in a hospital, and $389 per day for days 61-90. In a skilled nursing facility, you could pay $194.50 per day for days 21-100.

With a Medicare Advantage plan, copayments may differ from Original Medicare, as plans can set their rates.

This includes potential variations in deductibles, coinsurance, and copays for physical therapy services.

Some plans may also require prior authorization or have specific network requirements for therapy providers.

It’s best for you to consult your plan to understand the precise costs and coverage guidelines for physical therapy.

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