Medicare & Physical Therapy: What’s Covered

What Medicare Part B covers

Medicare Part B covers outpatient physical therapy that is medically necessary — meaning a licensed therapist documents that skilled care is needed to treat your condition or maintain your function. That includes evaluation, hands-on treatment, therapeutic exercise, and balance or gait training.

There is no hard annual visit cap. Above an annual dollar threshold, your therapist simply documents continued medical necessity — a routine step at any well-run clinic. What matters is that care is genuinely helping, which we measure and share with you at every stage.

What you pay

• After your Part B deductible is met, Medicare pays 80% of the approved amount; you (or your supplemental plan) pay 20%.
• Medigap / supplement plans typically cover that 20% — many of our Medicare patients pay nothing out of pocket.
• Medicare Advantage plans vary: copays and prior authorization differ by plan. We check yours before you start.

Do I need a referral?

You can begin evaluation under New Jersey direct access, and Medicare requires your plan of care to be certified by a physician or qualified provider — a signature we obtain for you as part of routine paperwork. It rarely delays starting care.

Common Medicare-covered goals we treat

• Balance and fall prevention — see our program
• Strength and independence — senior mobility
• Joint replacement recovery — post-surgical rehab
• Arthritis pain — arthritis management