Does Medicare Cover Physical Therapy For Back Pain?

Back pain is pretty common nowadays. In fact, 8 out of 10 people in the U.S. deal with it at one point or another.

While it is common, it’s something you don’t want to take lightly. Sure, sometimes resting or stretching may do the trick. But sometimes medical attention is needed.

And one of the best ways to treat back pain is through physical therapy. This is because it’s non-invasive, can be relaxing and you don’t necessarily have to take any meds.

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

Does Medicare Cover Physical Therapy For Back Pain?

The short answer is yes; Medicare will cover the cost of physical therapy for back pain. 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 physical therapy for back pain. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for physical therapy for back pain. Physical therapy is usually covered under Medicare Part B. Physical therapy generally falls under the blanket of “medically necessary” services. Though some physical therapists offer preventive services to minimize risks of surgery.

Medicare Part A may provide coverage for physical therapy services if a patient needs it while staying in a hospital or an inpatient setting. In addition, part A also funds physical therapy if it will be performed in a skilled nursing facility (SNF) after a hospital stay.

Medicare Advantage plans (Medicare Part C) also provides coverage for physical therapy. Because Part C covers everything Original Medicare covers and more. If you have an Advantage plan, be sure to check with your plan provider to find out exactly what your plan covers.

Also keep in mind that, if you have Medicare Part C, your plan may require you see in-network physical therapists in order to get coverage.

How Much Does Physical Therapy Cost?

Physical therapy can cost $20 to $55 per session.

How Does Physical Therapy Help With Back Pain?

Generally, the goal of physical therapy is to reduce pain all over the body and to restore and improve body function. It can also help in preventing some pain from occurring again.

Physical therapy for back pain can be done in two ways, through passive physical therapy and active exercises. Passive therapy mostly focuses on decreasing pain through the use of modalities. Some of those modalities include:

Heat/ice packs
Ultrasound
TENS devices
Iontophoresis

Active exercises aim to rehabilitate the person’s spine. One of the exercises that can help in reducing back pain is stretching. Stretching doesn’t take a lot of time and is most effective when you do it every day (even if you’re not currently experiencing back pain).

There are also strengthening exercises that can prevent back pain. For example, you can do 15 to 20 minutes of dynamic lumbar stabilization every day to strengthen the back. Core muscle exercises can prevent back pain too.

Another way to reduce back pain is through doing low-impact aerobic conditioning. There are many aerobic exercises that many people can do including walking, biking, and swimming.

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.