Does Medicare cover physical therapy at home? A plain-language guide

"Does Medicare cover this?" is one of the first questions we hear. For physical therapy at home, the honest answer is often yes — but there are two different routes, and they work differently.

Route one: outpatient therapy under Part B

Medicare Part B covers medically necessary outpatient physical therapy. "Outpatient" describes the type of service, not the location — a Medicare-enrolled physical therapist can provide Part B outpatient therapy in your home.

What this generally looks like:

• You don't need to be homebound. You can still drive, run errands and leave the house.
• A plan of care is required. Your therapist writes it after evaluating you, and a physician or qualified practitioner certifies it.
• Standard Part B costs apply. After you meet the annual Part B deductible, you typically pay 20% of the Medicare-approved amount. A Medigap or supplemental plan may cover some or all of that.
• There's no hard annual cap. Medicare sets a yearly dollar threshold; above it, your therapist confirms that continued therapy is medically necessary, and coverage continues when it is.

Route two: home health under Part A or B

Medicare's home health benefit is a separate program, delivered by a Medicare-certified home health agency. It can include physical therapy alongside nursing and other services.

The key difference: to qualify, you generally need to be homebound, meaning leaving home takes considerable effort, and you need to be under a doctor's care with a face-to-face encounter documented. When you qualify, covered home health services typically cost you nothing.

Many people recovering at home don't meet the homebound standard — they're simply better served by therapy at home. For them, Part B outpatient therapy is usually the right path.

Medicare Advantage plans

If you have a Medicare Advantage (Part C) plan, it must cover everything Original Medicare covers, but the rules — networks, prior authorization, copays — are set by the plan. Your out-of-pocket cost may be a flat copay per visit instead of 20% coinsurance.

Questions worth asking

Before your first visit, it's worth knowing:

1. Is the therapist enrolled with Medicare (or in-network with my Advantage plan)?
2. Does my plan require prior authorization for PT?
3. What will I owe per visit after my deductible?
4. Who handles the physician certification of my plan of care?

At Bluefin, our team answers these for you when we verify your coverage — before your first visit is confirmed.

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Medicare rules change and individual plans vary. This article is general information; confirm details with Medicare (1-800-MEDICARE or medicare.gov) or your plan.