Physical therapy (PT) is a crucial part of rehabilitation and recovery for many seniors. If you’re enrolled in Medicare and need PT services, it’s essential to understand how much Medicare pays for physical therapy per visit, your potential out-of-pocket costs, and the coverage limits.
Medicare Coverage for Physical Therapy: An Overview
Medicare primarily covers physical therapy under Part B (Outpatient services). In some cases, Part A (Inpatient care) also provides coverage if you’re admitted to a hospital or skilled nursing facility.
Medicare Part B and Physical Therapy
Medicare Part B covers 80% of the Medicare-approved amount for outpatient physical therapy services after you’ve met your annual Part B deductible, which is $240 in 2025. The remaining 20% coinsurance is your responsibility, unless you have supplemental insurance such as Medigap or Medicare Advantage that covers this cost.
đź’ˇ Example Cost:
If the Medicare-approved amount for one physical therapy visit is $100, Medicare pays $80, and you pay $20.
How Many PT Sessions Does Medicare Pay For?
Medicare does not limit the number of physical therapy sessions as long as they are medically necessary. However, there is a soft cap for therapy services.
2025 Threshold Amounts:
Medicare sets an annual therapy threshold, above which your provider must document the medical necessity of continued treatment:
- $2,330 for physical therapy and speech-language pathology combined
- $2,330 for occupational therapy separately
If your therapy costs exceed this threshold, your therapist must add proper documentation and justification for continued care.
What Is the 21-Day Rule for Medicare?
The 21-day rule applies specifically to Medicare Part A coverage in skilled nursing facilities (SNFs). Medicare pays in full for the first 20 days of inpatient rehab, including physical therapy, after a qualifying 3-day hospital stay. Starting on day 21 through day 100, you pay a daily coinsurance (in 2025, it’s $204 per day).
If you continue inpatient therapy beyond 100 days, Medicare coverage ends unless you’re eligible again after a new qualifying stay.
How Much Does Medicare Pay Per Therapy Session?
As mentioned, Medicare generally covers 80% of the approved cost for outpatient physical therapy services. The exact payment per session depends on:
- The type of therapy
- The provider’s billing
- Your geographic location
Typical Medicare-approved rates range between $70–$150 per session depending on complexity and duration.
Does Medicare Pay for Inpatient Physical Therapy?
Yes. If you’re hospitalized or in a skilled nursing facility, Medicare Part A covers inpatient physical therapy as part of your overall inpatient stay:
- Hospital: Covered during your inpatient hospitalization
- SNF: Covered up to 100 days per benefit period (after a 3-day hospital stay)
Medicare Part A has different cost structures, such as deductibles and coinsurance based on your length of stay.
How to Reduce Your Out-of-Pocket Costs
To minimize costs:
- Use Medicare-participating providers (accepting assignment)
- Enroll in a Medicare Supplement (Medigap) plan to cover your 20% coinsurance
- Consider Medicare Advantage (Part C) plans that may offer lower co-pays or bundled services
Final Thoughts
Understanding how much Medicare pays for physical therapy per visit helps you plan for your rehabilitation needs and manage costs effectively. Whether receiving outpatient care or recovering in a skilled nursing facility, Medicare offers substantial support—but it’s important to track your expenses, know the thresholds, and explore additional coverage options.
