Is Medicare Physical Therapy Covered at Home? 

Physical therapy is a first-line treatment for many injuries and illnesses. The goal of physical therapy is usually to rehabilitate an injury instead of cure a condition; however, physical therapy may be used during the course of more intensive treatments or after surgery.

For many people, physical therapy services are offered in a clinical setting like a physical therapist’s office, a diagnostic lab or a hospital’s rehabilitative wing. While this provides easy access to medical professionals for the patient, it may also make it more difficult to receive treatment if someone is already dealing with mobility concerns that make attending office visits challenging.

Physical Therapy in the Home

To overcome these challenges, physical therapy services can sometimes be provided in a patient’s home. The efficacy of providing at-home physical therapy services will be determined by the extent to which services are needed.

In some situations, physical therapy sessions may require the use of special equipment that is not able to be transported easily or that would be inefficient in a patient’s home. In such cases, home services may not be possible.

If home physical therapy is possible, it generally involves light body exercises that include stretching, muscle training and coordination practice. The extent to which these exercises will be required largely depends on the condition they have been prescribed to treat.

Is Medicare Physical Therapy Covered at Home?

Medicare typically covers physical therapy through Part B. This is outpatient care coverage, and it helps to pay for things like doctor visits, clinical treatment and durable medical equipment (DME). Most physical therapy takes place in an outpatient setting, but when it takes place in the home through a visiting medical service, Medicare coverage works a little bit differently.

Home health services, including physical therapy, are covered by Original Medicare through Part B, but coverage may be supplied through Medicare Part A, the inpatient benefit, if services are rendered by a member of a hospital’s staff. Even if you are not hospitalized, your coverage is based on who is providing the service and what their status is in relation to Medicare.

In order to receive coverage for home health services, including physical therapy, your doctor or treatment team will need to deem the physical therapy medically necessary. Additionally, you will need to be current on any premiums involved in your Medicare enrollment, and all deductibles will need to be met before benefits begin to apply toward your services.

What Does Medicare Pay For?

One of the advantages home health services provide under Medicare Part B is the DME coverage mentioned above. Because physical therapy often requires the use of DME, including items like railings and walkers, Medicare recipients who require these items during physical therapy can have DME covered alongside physical therapy in the home. Medicare will also pay for a physical therapist’s visit to your home, and some additional services like medication injections may be covered.

Do Medicare Advantage Plans Cover At-Home Physical Therapy?

Medicare Advantage plans include the same Part A and Part B as Original Medicare , but they often offer additional benefits. This means that Medicare Advantage plans will cover physical therapy in the home, but they may also provide access to supportive therapies like gym glasses or nutrition classes that are designed to assist people during rehabilitation after an injury or illness. Each Medicare Advantage plan and provider are different, so you are encouraged to work with an independent Medicare broker who can impartially shop plans for you to compare.