Does Medicare cover physical therapy in 2025? If you’re recovering from surgery, managing chronic pain, or simply trying to stay mobile, this is one of the most important questions you can ask. Many seniors assume Medicare covers everything—until they receive unexpected bills, reach their visit limits, or are denied coverage.
In this blog, we’ll break down everything you need to know about Medicare and physical therapy in 2025: what’s covered, how much you’ll pay, which plans offer better support, and how to get the care you need without overpaying.
Skyline Benefit is a top-rated Medicare broker in California, helping you avoid common mistakes and make smart decisions that support your long-term recovery.
What Physical Therapy Does Medicare Cover in 2025?
Medicare does cover physical therapy in 2025—but only when it’s medically necessary and prescribed by your doctor. Covered services include:
- Outpatient physical therapy (Medicare Part B)
- Inpatient rehab during a qualified hospital or SNF stay (Medicare Part A)
- In-home physical therapy for homebound individuals
- Skilled nursing facility physical therapy
If your therapy is provided by a licensed professional at a Medicare-approved facility, and your doctor confirms it’s needed, it will be covered—at least partially.
How Medicare Part B Covers Physical Therapy in 2025
Outpatient therapy is covered under Medicare Part B. Here’s what you pay:
- $240 deductible (2025)
- After that, Medicare pays 80%
- You pay 20% coinsurance
There is no strict session limit, but once your therapy costs exceed approximately $2,330, Medicare requires your provider to submit stronger documentation proving medical necessity to continue.
Does Medicare cover physical therapy in 2025? Yes, but documentation matters if you go beyond the annual threshold.
Common Therapy Codes Medicare Uses
If you check your Explanation of Benefits or Medicare Summary Notice, you might see:
- 97110 – Therapeutic exercises
- 97140 – Manual therapy
- 97530 – Functional mobility training
- 97161–97163 – PT evaluations
- G0283 – Electrical stimulation therapy
These are standard CPT codes used to bill for covered physical therapy services.
Does Medicare Cover At-Home Physical Therapy in 2025?
Yes—if you qualify for Medicare home health services, physical therapy can be delivered in your home. You must:
- Be homebound and under a doctor’s care
- Have a Medicare-certified agency provide the therapy
- Need therapy to improve or maintain function
This benefit is powerful but underused. Ask your doctor if you qualify.
How Do Medicare Advantage Plans Cover Physical Therapy?
If you’re enrolled in a Medicare Advantage (Part C) plan:
- You may pay less per visit (e.g., fixed copays)
- Some plans offer more covered visits
- Many include tele-rehab or wellness benefits
- Prior authorization may be required
- In-network care is often mandatory
Advantage plans often add value—but only if you follow their rules and provider networks.
How Many Therapy Sessions Does Medicare Cover in 2025?
There is no hard cap, but Medicare monitors your usage. Once your yearly costs exceed approximately $2,330, your therapist must justify continued care through documentation.
As long as it’s helping you recover or prevent deterioration, Medicare should keep covering your sessions.
Who Qualifies for Medicare-Covered Physical Therapy in 2025?
You’re eligible for physical therapy under Medicare if:
- You’re enrolled in Part B or a Medicare Advantage plan
- A doctor prescribes the therapy
- A licensed provider performs the service in an approved setting
From joint replacement recovery to chronic conditions like arthritis, Medicare physical therapy coverage supports many types of needs.
Real-Life Example: What You’ll Pay
You injure your shoulder and need outpatient therapy three times a week.
- Each visit costs $100
- Medicare pays $80
- You pay $20 per visit after deductible
- If you have Medigap, it could cover your 20%
- If you have Medicare Advantage, your cost may be a lower flat copay
Understanding these costs helps avoid surprises.
Need Help Understanding Medicare and Physical Therapy in 2025?
Skyline Benefit is an independent health insurance broker in Fullerton, CA that offers affordable and flexible Medicare options. We will help you compare Original Medicare, Medicare Advantage, and Medigap options that best support your therapy and recovery goals.
Schedule a consultation today. Call us at: (714) 888-5112