Medicare - Covered Outpatient Skilled Therapy


Original Medicare covers medically necessary outpatient skilled therapy from licensed therapists or skilled therapy providers. There are 3 main types: 

  • Physical Therapy (PT) 
    Medicare Part B (Medical Insurance) helps pay for medically necessary outpatient physical therapy. You will still be responsible for paying 20% of the Medicare approved amount and the Part B deductible applies.

    https://www.medicare.gov/coverage/physical-therapy
    Click on web link above to more details directly from Medicare.gov

  • Speech/Language Pathology (SLP)
    Medicare Part B (Medical Insurance) helps pay for medically necessary outpatient speech-language pathology. You will still be responsible for paying 20% of the Medicare approved amount and the Part B deductible applies.
    https://www.medicare.gov/coverage/speech-language-pathology-services
    Click on web link above to more details directly from Medicare.gov

  • Occupational Therapy (OT)
    Medicare Part B (Medical Insurance) helps pay for medically necessary outpatient occupational therapy. You will still be responsible for paying 20% of the Medicare approved amount and the Part B deductible applies.
    https://www.medicare.gov/coverage/occupational-therapy
    Click on web link above to more details directly from Medicare.gov


What is considered Physical Therapy?
Exercise and physical activities used to condition muscles and improve levels of activity. It is helpful for those with physically debilitating illness. Physical Therapy will help you regain movement and strength in a body area.

Note: Medicare law no longer limits how much it pays for your medically necessary outpatient therapy services in one calendar year.
Also keep in mind that your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.


What is considered Speech/Language Pathology?
Therapeutic treatment of speech impairments (such as lisping and stuttering) or speech difficulties that result from illness. Speech/Language Pathology will help you regain and strengthen speech and language skills.


What is considered Occupational Therapy?
Therapy using meaningful activities of daily living to assist people who have difficulty acquiring or performing meaningful work due to impairment or limitation of physical or mental function. OT helps you regain the ability to do usual daily activities by yourself such as eating and putting on clothes.




Source: Medicare.gov


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