Physical therapy is one of the most common types of non-medicinal treatments for injuries, and the practice of physical therapy is used in both rehabilitation as well as in preventative treatment. As you age, your body naturally takes longer to heal from injuries and may also require more time to regenerate cells after trauma.
Physical therapy may be able to assist in speeding these processes along, but how effective your treatment will be depends largely on the type of injury and any contraindications that prevent physical therapy from doing its job. In many cases, physical therapy is used alongside other treatment solutions to form a comprehensive treatment plan after suffering from an illness or injury.
Does Medicare Cover Physical Therapy?
If you’re enrolled in Medicare, you’ll be happy to know that Original Medicare provides a number of benefits for physical therapy. Medicare physical therapy benefits are usually provided by Medicare Part B, the outpatient portion of Medicare.
This is because most physical therapy treatments are provided in a clinical setting or doctor’s office, but Medicare also covers physical therapy that is required while admitted to a hospital. This type of coverage is supplied through Medicare Part A, the inpatient benefit.
What Does Medicare Pay For If You Need Physical Therapy?
In terms of coverage, Medicare physical therapy benefits cover the actual visits with a physical therapist as well as treatments administered during these visits. Medicare does not, however, cover the cost of traveling to and from a visit.
This is important to note because many people who need physical therapy often face mobility challenges. If this is your case, you will need to arrange for transportation ahead of time. Many community programs do offer free or discounted transport to medical visits based on location.
Medicare may also pay for medical equipment to be used in conjunction with physical therapy. Medicare considers items like wheelchairs and walkers durable medical equipment (DME), and this equipment is covered under Medicare Part B.
In order for benefits to apply, you must buy or rent DME from a Medicare-approved supplier, and your plan may have specific restrictions on the quantities of items you can purchase or rent. Additionally, your plan may require you to rent an item for a certain length of time before Medicare physical therapy benefits will apply toward a purchase.
Your Obligations and Restrictions
In an inpatient scenario, Medicare pays for your physical therapy services while admitted, but as stated above, this is done through Medicare Part A while outpatient services are covered through Medicare Part B. This means that your inpatient services will only be covered while admitted. If you require continued physical therapy after you are released from a hospital or skilled nursing facility, coverage reverts back to Medicare Part B.
This is important to take note of since your cost obligations change as a result. Medicare physical therapy benefits under Part A will be available for up to 60 days at no cost during each benefit period. After you have reached day 61, you can continue to receive coverage for inpatient physical therapy for an additional 30 days at a discount. Upon reaching day 91 of an inpatient stay, you will need to rely on lifetime reserve days or pay 100% of the cost of your care until the next benefit period begins.
Medicare Part B typically requires a deductible, so your physical therapy benefits will not actually begin until you have met the deductible through out-of-pocket payments. Likewise, Medicare Part B typically include a monthly premium that must be current in order to access benefits even after your deductible has been met.
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