Does Medicare Cover Therapy at Home?
Short answer
Medicare can cover skilled physical therapy, speech-language pathology and certain occupational therapy through the home-health benefit when the beneficiary meets home-health eligibility requirements.
Coverage
The beneficiary generally must be homebound and need qualifying intermittent skilled services under a practitioner-established plan of care, with care furnished by a Medicare-certified home health agency.
Not Automatic
Therapy must be skilled and medically necessary. Routine exercise, general supervision or personal assistance alone is not covered as home-health therapy.
Costs And Ma
Home-health coverage has its own cost rules. Medicare Advantage may use network home-health agencies or authorization.
Practical Example
A homebound beneficiary recovering from a stroke may receive covered home PT and speech therapy when a certified agency provides the skilled services under a qualifying plan of care.
Questions to verify
- Do I meet the homebound criteria?
- Is the therapy skilled and medically necessary?
- Is the agency Medicare-certified or in-network?