Physical therapy is a type of rehabilitative care that focuses on improving mobility, managing pain, and, in some cases, preventing disability. Many seniors rely on physical therapy after surgery, sustaining an injury, or to help manage a chronic condition, like arthritis or osteoporosis.
Thankfully, Medicare typically covers medically necessary physical therapy. But exactly how much Medical pays for will vary depending on several factors, including what type of coverage you have.
Understanding your physical therapy costs can help with treatment planning. In this article, we’ll cover how much Medicare pays for physical therapy per visit according to your coverage. We’ll also explain how to get your physical therapy approved and what to do if your claims are denied.
Key takeaways
Medicare Part B covers 80% of the approved amount for medically necessary physical therapy after you meet the $283 annual deductible (2026).
Though there is no limit to how much Medicare pays for medically necessary physical therapy in one year, you’ll need to provide documentation for Medicare to continue to cover services that exceed the $2,480 annual threshold amount.
Medicare Advantage plans also cover physical therapy, but how much you’ll pay depends on your specific plan.
How common is physical therapy among seniors?
According to an analysis from 2019, an estimated 40-43% of people who receive physical therapy are aged 65 or older.
As the U.S. population continues to age, experts expect the need for physical therapy and rehabilitative care to grow, particularly among older adults who are disproportionately affected by chronic conditions.
Examples of conditions that may benefit from physical therapy include:
Arthritis
Osteoporosis
Musculoskeletal disorders
Vertigo
Cancer recovery
Injury (including from falls)
Does Original Medicare pay for physical therapy?
Yes, Original Medicare helps cover the cost of medically necessary physical therapy.
How much does Medicare Part A pay for physical therapy?
Though most physical therapy takes place in an outpatient setting, like a doctor’s office or physical therapy facility, if you receive physical therapy as part of your inpatient or hospital treatment, Part A covers 100% of the cost for the first 60 days of your hospital stay after you meet your deductible ($1,736 in 2026).
How much does Medicare Part B pay for physical therapy?
Part B covers 80% of the Medicare-approved amount of your outpatient physical therapy costs after you meet your deductible ($283 in 2026).
Factors affecting physical therapy costs
There are several factors that can impact your out-of-pocket physical therapy costs, including:
Where you live
The condition being treated
If you have additional healthcare insurance or coverage
How much your physical therapist charges
Whether or not your physical therapist accepts assignment
The type of facility in which you receive treatment
Annual therapy thresholds
There is no limit to how much Medicare Part B will pay for your physical therapy in one calendar year.
However, there is a combined $2,480 annual threshold (2026) for physical therapy and speech-language pathology services.
If your physical therapist or healthcare provider recommends additional physical therapy beyond this threshold amount, you’ll need to provide documentation demonstrating that further physical therapy is medically necessary for Medicare to cover the cost of these additional visits.
Medicare Advantage physical therapy coverage
Medicare Advantage plans offer the same coverage as Original Medicare’s Part A and Part B, including physical therapy.
But with Medicare Advantage, there is no standard out-of-pocket expense. While with Part B you’ll always pay 20% of the approved amount per visit, your copayment and coinsurance rates with Medicare Advantage will vary depending on your specific policy.
It’s also important to note that many Medicare Advantage plans require prior authorization in order to receive services like physical therapy.
Getting physical therapy approved and covered
For Part B to cover 80% of the approved amount of each visit, your physical therapy needs to be deemed “medically necessary.” This occurs when your healthcare provider refers you to physical therapy to diagnose or treat a condition, injury, or illness.
You’ll also need a treatment plan from your healthcare provider. Your provider is responsible for relaying this plan to Medicare, which may check in from time to time to ensure that your physical therapy is still medically necessary.
But you don’t need prior authorization or any other kind of documentation when seeking care below the $2,480 annual threshold amount with Original Medicare.
If you’re seeking care above the annual threshold, you’ll need to submit a claim to prove that the therapy is still medically necessary. The claim will include documentation from your physical therapist about your diagnosis, treatment goals, and the total number of sessions required.
If you have Medicare Advantage, you may need prior authorization before your plan will cover the cost of the service. You can refer to your specific plan’s coverage for more details.
What to do if claims are denied
If a claim or prior authorization is denied, you may have the opportunity to appeal. If you choose not to appeal or if the appeal is unsuccessful, you can pay the full cost of your physical therapy sessions out of pocket.
Bottom line
If deemed medically necessary, Original Medicare will help cover the cost of physical therapy.
If you require physical therapy as part of an in-hospital stay, Part A covers the full cost of physical therapy for the first 60 days after you meet your $1,736 deductible.
If you’re seeking medically necessary, outpatient physical therapy, Part B will cover 80% of the approved amount of each visit after you meet the $283 annual deductible.
Medicare Advantage plans also cover physical therapy, but copayment amounts will vary depending on your specific plan’s benefits. Some Medicare Advantage plans also require prior authorization before covering the cost of physical therapy.
Frequently asked questions
How much does Medicare pay for physical therapy per visit?
Medicare Part B pays 80% of the Medicare-approved amount after you meet the $283 annual deductible for 2026.
Is there a limit on physical therapy with Medicare?
No, there is no limit to how much physical therapy you receive in one year if you have Medicare. However, there is a combined $2,480 annual threshold for physical therapy and speech-language pathology services. If your provider recommends additional physical therapy beyond this amount, you’ll need to provide documentation demonstrating that further physical therapy is required in order for Medicare to cover the cost of those additional visits.
Does Medicare cover physical therapy at home?
Yes, Medicare Part B covers home health physical therapy when you’re homebound and meet certain conditions, for instance, when leaving your home isn’t recommended because of your condition.
Sources
Arena, S. K., Wilson, C. M., Boright, L., Webster, O., Pawlitz, C., Kovary, C., & Esper, E. (2023). Medical Clearance of Older Adults Participating in Preventative Direct Access Physical Therapy. Cureus, 15(3), e35784.
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Administration for Community Living & Administration on Aging. (2019). 2019 PROFILE OF OLDER AMERICANS. In Administration for Community Living. https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2019ProfileOlderAmericans508.pdf
V. Oster, N., PhD, MPH, M. Skillman, S., MS, A. Stubbs, B., MPH, Dahal, A., PhD, Guenther, G., MPA, & K. Frogner, B., PhD. (2020). The physical therapist workforce in the U.S.: supply, distribution, education pathways, and state responses to the COVID-19 emergency. In University of Washington Center for Health Workforce Studies. https://familymedicine.uw.edu/chws/wp-content/uploads/sites/5/2020/11/PT_PB_Nov_23_2020.pdf
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Centers for Medicare & Medicaid Services. (2026, January 14). 2026 Medicare Part B premiums & deductibles. https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
Centers for Medicare & Medicaid Services. (2025). Medicare physician fee schedule final rule summary: Calendar year 2026.
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