Best Physical Therapists That Accept Medicare in 2021
Physical therapists that accept Medicare will apply your coverage to any medically necessary physical, speech, or occupational therapies, but updates to the Medicare physical therapy guidelines put a $2,100 threshold on therapies that aren't medically prescribed. If your physical therapy isn't a medical necessity, Medicare will not cover it, and you may need to buy supplemental health insurance coverage to cover physical therapy costs.
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UPDATED: Nov 24, 2021
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- Medicare will cover any physical therapy, speech therapy, or occupational therapy that is deemed medically necessary
- Physical therapists that accept Medicare are held to strict medical guidelines
- New Medicare physical therapy guidelines place thresholds on therapies that aren’t a medical necessity
Recent changes to the Medicare physical therapy guidelines 2021 include new thresholds for therapies that are not medically necessary.
In 2018, Medicare law removed the limits on annual physical and occupational therapy coverage.
But the Centers for Medicare and Medicaid Services (CMS) recently updated the terms regarding therapy thresholds.
These new thresholds can limit Medicare coverage for physical therapy that is not deemed medically necessary by CMS. Keep in mind, if you have an individual health insurance plan, physical therapy costs may still be covered.
You can learn more about the new guidelines and how to find affordable physical therapists that accept Medicare near you in this article.
Are you looking for health insurance coverage for physical therapy? Of course, Medicare is not your only option. You can find affordable coverage from insurers near you. Enter your ZIP code above to start comparing health care plans for free.
How do I find physical therapists that accept Medicare?
Physical therapists that accept Medicare have to apply to participate in the program and are held accountable with routine surveys and check-ins about meeting the medical standards set by CMS.
These regulations are renewed annually. Furthermore, physical therapists and other health care providers must continue to meet these requirements. This ensures that patients are receiving the highest quality care with their Medicare plan.
Finding physical therapists near you that accept Medicare is easy.
Medicare provides helpful tools for policyholders to find local physical therapists, but your coverage will depend on the type of Medicare policy you have and why you need physical therapy.
Most Medicare policies will cover any physical therapies, including occupational and speech therapies, that are medically necessary. But if your physical therapy is not prescribed by a doctor, Medicare will not cover it.
If you carry additional health insurance, you may be able to apply that coverage and reduce your costs too. You can compare health insurance quotes and coverage online to find a plan that fits your needs and supplement any existing coverage you have through Medicare.
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How much do Medicare physical therapy providers cost?
On average, physical therapy can cost between $75-$350 per session.
These costs can vary based on the type of therapy and the condition being treated. Ultimately, how much you pay for physical therapy depends on your health insurance plan, your deductibles, and coinsurance.
How much physical therapy costs on Medicare is determined by the type of policy:
- If you carry Medicare, all medically necessary inpatient physical therapy is covered by Medicare Part A.
- Outpatient therapies performed at doctors’ offices or skilled nursing facilities are covered by Part B, minus your deductible, which averages around $200.
- If you carry Part C, also known as a Medicare Advantage Plan, you may have additional coverages that can be applied to your physical therapy costs.
Will Medicare cover all these physical therapy costs?
Medicare Part A typically covers most, if not all, of your inpatient physical therapy services. On the other hand, Part B requires that you meet the deductible before outpatient services are paid for. You are also required to pay 20% of the Medicare-approved amount on your policy with Part B.
The Medicare-approved amount for physical therapy also varies depending on the type of facility and doctor you choose. Medicare physical therapy providers charge their own rates for certain therapies. Equally important, Medicare can cover some or all of the costs depending on your policy type.
Make sure you have the right Medicare policy in place before you start physical therapy to ensure your costs are covered. Recent changes to the Medicare physical therapy guidelines in 2021 have reinstated therapy threshold limits of $2,100 on outpatient services.
Per the Medicare Part B plan, this means that Medicare will cover up to $1,664 of physical therapy costs before it reassesses whether your treatment is still medically necessary. If not, policyholders are responsible for paying any costs exceeding this threshold out of pocket.
How do I find physical therapy near me that accepts Medicaid?
Unlike Medicare, Medicaid is dependent upon state insurance laws. Where you live determines if you qualify for Medicaid coverage. If you do, you will receive an enrollment card that you can use to get coverage with participating doctors, hospitals, and physical therapists.
If you don’t qualify for Medicaid in your state, you can still find affordable health insurance near you.
Comparison shopping online is the easiest way to find the cheapest health care provider that covers physical therapy in your neighborhood. Enter your ZIP code below to start comparing free health insurance quotes from insurers in your area.