Coverage by Plan Type
How physical therapy coverage works under each Medicare plan type.
Original Medicare (Part B)
Covered with LimitsMedicare Part B covers medically necessary physical therapy, occupational therapy, and speech-language pathology services when ordered by a physician and provided by a Medicare-enrolled therapist. There is no longer a hard annual dollar cap on therapy services. However, you must show continued medical necessity for treatment to continue. You pay 20% coinsurance after the Part B deductible for each visit.
Medicare Part A (Inpatient / Skilled Nursing)
Covered During Qualifying StaysIf you are admitted to a hospital or a Medicare-certified skilled nursing facility (SNF), physical therapy provided as part of your care is covered under Part A. To qualify for SNF coverage, you must have had a qualifying inpatient hospital stay of at least 3 days. Part A covers the full cost of therapy during days 1 through 20 of a SNF stay (after the Part A deductible of $1,736 per benefit period). Days 21 through 100 require a daily coinsurance of $212 in 2026.
Medicare Advantage (Part C)
Covered + Possible ExtrasMedicare Advantage plans must cover physical therapy at least as generously as Original Medicare. Many plans offer lower copays per visit or additional therapy visits beyond what Original Medicare requires. Network restrictions apply: you must use in-network physical therapists. Some plans also cover fitness benefits or gym memberships that can complement physical therapy.
Medigap (Medicare Supplement)
Covers Cost-SharingMedigap plans cover the 20% Part B coinsurance you owe for outpatient physical therapy visits. For someone attending two or three sessions per week during a recovery period, this can add up to hundreds of dollars per month. Plan G covers the coinsurance entirely after the annual Part B deductible of $283 in 2026.
What Is and Is Not Covered
A complete list of therapy-related services under Original Medicare.
Outpatient physical therapy (PT) visits
Occupational therapy (OT) visits
Speech-language pathology (SLP) services
Physical therapy in a skilled nursing facility (Part A)
Physical therapy during inpatient hospital stay (Part A)
Home health physical therapy (if homebound)
Aquatic therapy (if provided by a Medicare-enrolled therapist)
Functional assessments and therapy evaluations
Maintenance therapy (to prevent decline)
Gym memberships or fitness classes
Massage therapy (not medically supervised PT)
Chiropractic care beyond spinal manipulation
Long-term custodial care or personal care assistance
Your Costs for Physical Therapy in 2026
What you can expect to pay under Original Medicare for PT services.
| Service | What Medicare Pays | What You Pay |
|---|---|---|
| Outpatient PT visit (per session) | 80% after deductible | 20% coinsurance + $283 deductible |
| Outpatient OT visit (per session) | 80% after deductible | 20% coinsurance |
| Speech-language pathology visit | 80% after deductible | 20% coinsurance |
| PT evaluation / initial assessment | 80% after deductible | 20% coinsurance |
| SNF physical therapy (days 1-20) | 100% after Part A deductible | $0 (after $1,736 Part A deductible) |
| SNF physical therapy (days 21-100) | All costs above daily coinsurance | $212/day coinsurance (2026) |
| Home health PT (if homebound) | 100% | $0 |
How Much Can Medigap Save You?
If you attend physical therapy three times per week at an average cost of $150 per session, your 20% share is $30 per visit, or about $360 per month. A Medigap Plan G covers that coinsurance entirely after the $283 annual deductible, saving you over $4,000 per year for ongoing therapy. Learn more about Medigap plans.
Physical Therapy Coverage in Brandon and the Tampa Bay Area
Local guidance for Hillsborough County Medicare beneficiaries.
Serving Brandon, Tampa, Riverview, Valrico, and Hillsborough County
Brandon and the greater Tampa Bay area have a large network of Medicare-accepting physical therapy providers, including outpatient clinics affiliated with BayCare Health System, AdventHealth, and HCA Florida Brandon Hospital. Residents of Riverview, Valrico, and other Hillsborough County communities generally have multiple in-network options close to home.
If you have Original Medicare, you can use any Medicare-enrolled physical therapist in the area without network restrictions. If you have a Medicare Advantage plan, you should verify that your preferred PT clinic is in-network before beginning treatment, as out-of-network costs can be significantly higher.
For beneficiaries recovering from joint replacement surgery, stroke, or other major procedures at Brandon Regional Hospital or St. Joseph's Hospital, transitioning to an outpatient PT clinic or a skilled nursing facility for continued therapy is a common next step. Greg Wohl helps Brandon and Tampa Bay area residents understand how their Medicare coverage applies at each stage of recovery. Call 813-699-5559 for a no-cost consultation.
Related Coverage Questions
Frequently Asked Questions
Common questions about Medicare physical therapy coverage.
Questions About Your Physical Therapy Coverage?
Whether you are recovering from surgery or managing a chronic condition, the right Medicare plan can significantly reduce your therapy costs. Greg Wohl can help you compare your options.