Medicare Part B covers medically necessary outpatient An outpatient is a patient who has not been formally admitted into the hospital as an inpatient. Most outpatient care is covered under Medicare Part B (medical insurance). therapy services, including:
- Physical therapy Physical therapy is exercise and physical activities used to condition muscles and regain movement and strength in a body area. It is helpful to improve or restore physical function for those with debilitating illness or injury.
- Speech-language pathology Speech-language pathology, also known as speech therapy and language therapy, is treatment to regain and strengthen speech and language skills. services
- Occupational therapy Occupational therapy is therapy that helps you regain the ability to do usual daily activities by yourself, such as eating and putting on clothes.
If you meet Medicare’s eligibility requirements, Medicare covers therapy on a temporary basis to improve or restore your ability to function, or on an ongoing basis to prevent you from getting worse. Medicare should cover your outpatient therapy regardless of whether your condition is temporary or chronic.
Eligibility
You are eligible for Medicare coverage of outpatient therapy services if:
- You need skilled therapy services, and the services are considered safe and effective treatment for you
- Medicare defines skilled care as care that must be performed by a skilled professional, or under their supervision
- Your doctor or therapist creates a plan of care before you start receiving services
- Your doctor or therapist regularly reviews the plan of care A plan of care is a doctor’s written plan describing the type and frequency of health services a particular patient needs. and makes changes as needed
You can get therapy services in a doctor’s office, outpatient hospital setting, rehabilitation agency, Comprehensive Outpatient Rehabilitation Facility (CORF), public health agency, or your home. You can also get therapy while at a skilled nursing facility (SNF) or through a home health agency. However, you may need to meet additional eligibility requirements to receive Medicare SNF or home health coverage.
Costs
Original Medicare covers outpatient therapy at 80% of the Medicare-approved amount. When you receive services from a participating provider In Original Medicare, a participating provider is a health care provider who accepts Medicare and always takes assignment. They may not charge you more than Medicare’s approved amount. If you have Original Medicare and see a participating provider, you will pay a 20% coinsurance for Medicare-covered services. See also: Non-Participating Provider. , you pay a 20% coinsurance after you meet your Part B deductible ($257 in 2025).