Does Medicare Cover Vestibular Therapy?

Vestibular disorders affect our balance and vision. People who experience this type of disorder have trouble with dizziness, vertigo, and posture. Other symptoms may include fatigue, and nausea.

Vestibular Rehabilitation Therapy, or VRT for short, is a form of physical therapy that focuses on treating these issues. VRT is not a cure for these problems. Instead, it helps people who have them compensate so that they are better able to go about their daily activities.

If you are considering VRT, a common question you may have is “Does Medicare cover Vestibular Therapy?” In this article, we answer that question in clear, plain English. You will also find the average costs of vestibular rehabilitation therapy and other helpful info.

Does Medicare Cover Vestibular Therapy?

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

Original Medicare (Medicare Part A and Part B) provides coverage for vestibular rehabilitation therapy costs. As stated earlier, vestibular rehabilitation is a type of physical therapy, and Medicare usually includes coverage for physical therapy. Coverage for vestibular rehabilitation therapy falls under both Medicare Part A and Part B.

If you receive physical therapy while staying at a hospital as an inpatient, Medicare Part A may cover it.

Medicare Part B provides coverage for physical therapy that takes place in an outpatient setting. However, for Medicare Part B to cover any type of physical therapy, it has to be deemed medically necessary.

Physical therapy can be considered medically necessary if it will diagnose and/or treat various conditions, restore function, relieve pain, or increase mobility. Physical therapy services that delay the further deterioration of your condition fall under the category of a medically necessary treatment.

Your service provider should give you a written notice before providing you with a service that is not covered by Medicare Part B. You may receive physical therapy at the following facilities:

Medical offices
Private physical therapy facilities
Hospital outpatient departments
Home
Skilled nursing facilities if you are an outpatient

Medicare Advantage plans (Medicare Part C) also provide coverage for vestibular rehabilitation therapy. They cover everything Original Medicare covers as well as offer some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan.

How Much Does Vestibular Rehabilitation Therapy Cost?

The average costs of physical therapy are $75 to $150 per session, so you can expect that the cost for vestibular rehabilitation therapy to lie somewhere in that range.

However, the cost of physical therapy can go as high as $350. Several factors affect the overall cost of your physical therapy, such as:

The number of sessions you need
The experience level of your therapist/what kind of therapist they are
Your location
The type of facility you are using

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.