Does Medicare Cover Physical Therapy At Home?

Physical therapy is a common way to treat many types of chronic pain such as lower back pain. It is also used to relieve limited mobility in the joints or to help you recover from an injury or surgery.

Often people will go to a physical therapists office for treatment. But, in some cases, there’s an option to have the therapist come to you.

So a common question many people have is, “does Medicare cover physical therapy at home?” In this article, we answer that question in clear, plain English. You will also find the average costs of home service physical therapy, as well as other helpful info.

Does Medicare Cover Physical Therapy At Home?

The short answer is yes; Medicare will cover the cost of home service physical therapy. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your home service physical therapy. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for in-home service physical therapy. Coverage for home service physical therapy is provided by both Medicare Part A and Part B. Home service physical therapy is part of home health care which Medicare Part A and Part B cover.

However, for Medicare Part A or Part B to provide coverage for your home service physical therapy, there are certain conditions that you must meet. Those conditions are:

You must be under the care of your healthcare provider and your physical therapy must be part of a care plan that your healthcare provider reviews regularly
You must be certified homebound by your doctor
Your physical therapy must be performed by a qualified and Medicare-approved physical therapist
Your healthcare provider believes that physical therapy may improve your current medical condition

Medicare Part A and/or Part B will not provide coverage for home service physical therapy that is more than part-time or occasional.

Medicare Part A and/or Part B covers 100 percent of the costs of the home service physical therapy. However, you will pay for 20 percent of the costs of any Durable Medical Equipment, or also known as DME, that you may need as part of your treatment.

Part C and Part D Coverage for Physical Therapy At Home

Medicare Advantage plans (Medicare Part C) also provide coverage for physical therapy at home. They cover everything Original Medicare covers, as well as some additional benefits. However, exactly what it covers and how much the out-of-pocket costs are will vary depending on the specifics of your plan.

Medicare Part D will provide coverage for prescription medications that you may need as part of your physical therapy or recovery plan.

How Much Does Physical Therapy At Home Cost?

The average cost of home service physical therapy ranges from $100 to $150 per session. This price will vary between therapists. In-home physical therapy is more expensive than regular physical therapy.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.