Understanding Medicare Coverage for Physical Therapy

When it comes to providing premium physiotherapy treatments, Stern Therapy has set unparalleled standards. We have embarked on a mission to help our clients understand their healthcare benefits so they can maximize their physical therapy (PT) experience. In this light, let’s dive into the world of Medicare, and understand what PT services it covers.

Medicare: A Brief Overview

Medicare is a federal health insurance program, primarily for individuals aged 65 or older. However, it also extends coverage to certain younger people with disabilities or specific diseases. With Stern Therapy as your trusted healthcare partner, navigating through the complexities of Medicare doesn’t need to be a daunting task.

Types of Medicare

Before diving into specifics, it is essential to note that Medicare is divided into multiple parts. Part A covers hospital services, hospitality nursing, and home health care. Part B, on the other hand, covers outpatient care, preventive services, and yes, you’ve guessed it – physical therapy.

Your Bridge to Wellness: Medicare Part B

Let’s get this straight – Medicare Part B has got your back (and your knees, and shoulders, and everything in between) when it comes to physical therapy. It provides coverage for PT services that are deemed medically necessary by a healthcare provider. This means, as long as you require Physical Therapy to either maintain or improve your condition, Medicare has you covered.

Anatomy of Coverage

After paying the annual Part B deductible, typically, Medicare will cover 80% of the Medicare-approved amount for PT services, while you’ll be responsible for the remaining 20%. Remember, at Stern Therapy, we are committed to giving you the best care possible; hence, we will always guide you through the most cost-effective PT strategies.

Does Medicare Have Limits on Physical Therapy?

Historically, Medicare included a therapy “cap” or limit on PT services each calendar year. However, cheers to all those who pushed for advocacy, the caps were removed in 2018! So, currently, there’s no limit to improving and maintaining your health when you join hands with Stern Therapy.

Thresholds and Not Caps

While the term “cap” may be in the rearview, a therapy threshold still exists. This is an amount after which Medicare may require additional information to continue covering your PT services. It’s like a gentle speed bump on your journey to wellness. But don’t worry, our expert therapy team is always ready and eager to handle the paperwork roadblocks so you can stay focused on your recovery.

Physical Therapy Takeaway

Ultimately, it’s clear that Medicare can be a significant ally in your physical therapy journey. Armed with understanding and insight, you can make the most out of your benefits while capitalizing on the top-tier services offered at Stern Therapy. And you have our unfaltering support every step of the way. If you’re a physical therapist looking to be part of a forward-thinking, patient-oriented team, consider joining us. At Stern Therapy, we’re paving the way to a healthier nation, and you too could be a part of this remarkable journey!