I'm on Medicare Part B, and I'm wondering how my physical therapy visits are covered. Do I have to hit my deductible first?

Question

Wayne Rigby · Accepted Answer

I am assuming you are on Original Medicare Part B and not an Advantage plan.

Yes, you have to meet your Part B deductible then you would have copayments for those services.  The deductible this year is $257.

Terri Reagin · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/im-on-medicare-part-b-and-im-wondering-how-my-physical-therapy-visits-are-covered-do-i-have-to-hit-my-deductible-first#terri-reagin

Ben Washington · Answer

I'm on Medicare Part B, and I'm wondering how my physical therapy visits are covered. Do I have to hit my deductible first? Yes medicare has part B deductible of 257 then you will pay 20% of the cost. under original medicare. With a medicare Advantage plan you don't have me et a deductible under most plans.

Answered by Ben Washington on May 6, 2025

Broker Licensed in IL, FL, MN, SC, TX & WI

Answered by Ben Washington Medicare Insurance Agent

Robert Pennington · Answer

If your on Medicare A and B only you would 20%.  If your on a Medicare Advantage Plan, it usually has a copay that would be deductible for the MOOP.

Eli Roque · Answer

Yes you must pay Part B deductible and most like will have to cover 20% of the total cost of your physical therapy.Do to that Part B of medicare normanly cover 80% of total cost.( advise )Talk to doctor who referred to the therapy and the provider and figure out how long the treatments will be so you can figure out a budget.

Answered by Eli Roque on July 8, 2025

Broker Licensed in AZ, CA, FL & 8 other states

Answered by Eli Roque Medicare Insurance Agent

Robert Fracchia · Answer

After you meet your Medicare Part B deductible ($257), you typically pay 20% of the Medicare-approved amount for physical therapy. Medicare pays the remaining 80%

Kent Pike · Answer

If you have just Original Medicare, you would be obligated for any Medicare Services to reach the Part B deductible unless you have a Grandfathered Plan Such as Plan F.

Jesse Martinez · Answer

There are a few variables that go into that. Depending if you’re on original Medicare only or on an advantage plan. Most advantage plans allow physical therapy with the pre approval from a doctor for a specific copayment usually around $20-$40 per session. If you’re only on Part B ( no advantage plan) you will have to pay your deductible first usually around $240 or so. After that Medicare will cover 80% and you will pay the remaining 20% of the physical therapy cost.

Answered by Jesse Martinez on June 30, 2025

Agent Licensed in TX

Answered by Jesse Martinez Medicare Insurance Agent

Steven Bleicher · Answer

The Part B deductible in 2025 is $257.00. Once you go over that threshold, your PT is indeed covered by your Part B. This is determined by your doctor's “Plan of Care” which can be of any duration he sees fit. This can be increased if in the doctor’s assessment, you have not made as much progress as he initially thought. Medicare grants the doctor's opinions.

Answered by Steven Bleicher on May 26, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Timothy Brown · Answer

Physical therapy is covered under Medicare B (Outpatient Services) but it's the additional coverage (Medicare Supplement or Medicare Advantage) that what your coinsurance or copay:
If you have a Medicare Supplement, all cost that under Medicare Part B will be covered after the $257 annual deductible has been met. If you have a Medicare Advantage plan, you will have a copay for each physical therapy visit. The copay will be listed in the summary of benefits of the insurance carrier.

Rick Boyd · Answer

If your provider certifies that you need physical therapy, after your part B deductible, Medicare pays 80%, you pay the remaining 20%

Dionisio Guillermo · Answer

These visits are covered by Part B if it is ordered by a doctor as medically necessary. Part B covers 80% of the approved amount for the therapy service after applying the deductible and you are responsible for the 20% coinsurance.

Answered by Dionisio Guillermo on May 27, 2025

Agent Licensed in HI

Answered by Dionisio Guillermo Medicare Insurance Agent

Fred Manas · Answer

Yes, Medicare Part B requires you to meet your deductible before it begins covering physical therapy. The Part B deductible for 2025 is $257. Once you've met this deductible, Medicare will pay 80% of the Medicare-approved amount for your physical therapy, and you will be responsible for the remaining 20%. 
Elaboration:
Deductible:
Before Medicare starts paying for any covered services, including physical therapy, you'll need to meet your annual Part B deductible, which is $257 for 2025. 
Coinsurance:
Once your deductible is met, Medicare Part B typically covers 80% of the approved amount for physical therapy. You are then responsible for the remaining 20% (your coinsurance). 
Medigap:
If you have a Medigap plan, it may help cover the remaining 20% coinsurance, potentially reducing your out-of-pocket costs. 
Medically Necessary:
Medicare only covers physical therapy that is considered medically necessary to treat, diagnose, or monitor a health condition. 
Provider Notification:
If your provider believes your therapy may not be considered medically necessary, they must inform you in writing before providing the services.

Linda Davies · Answer

Medicare Part B typically covers 80% of the approved amount for physical therapy services after you meet your annual deductible, which is $257 in 2025. You are responsible for the remaining 20% (coinsurance), any copay, and costs not covered by Medicare.

Answered by Linda Davies on June 4, 2025

Agent Licensed in IL

Answered by Linda Davies Medicare Insurance Agent

Robert Remin · Answer

Robert Remin, expert Medicare plan advisor, licensed in NY, CT, NJ, and FL. If you have a balance or have not paid any of your part B deductible you will be billed for it once PT starts. Once deducttible paid you have unlimited zero cost PT visits each calendar year as long as Medicare deems they are medically necessary. FYI-If you have an additional private carrier Advantage plan or the G+ aka HDG plan you will have additional copayments besides part B original Medicare deductible

Answered by Robert Remin on July 28, 2025

Agent Licensed in NY, CT, FL & NJ

Answered by Robert Remin Medicare Insurance Agent

Bob Nunn · Answer

First not sure what rehab it is but if you go to Medicare.gov and download the 2025 Medicare and you book . Go to Section 2 : Find out what Medicare covers starting on page 25 .

Kevin Chaikin · Answer

Yes on traditional Part B you would need to pay your deductible first. Then, depending on your supplemental coverage you may have additional copays and as little as $0 extra cost for Physical Therapy.

Steven Rodriguez Giudicelli · Answer

Yes, you do have to meet your Part B deductible first. For 2025, the Part B deductible is $257.
Once you've paid that $257 for the year, Medicare Part B will generally cover 80% of the Medicare-approved amount for your physical therapy visits. You'll be responsible for paying the other 20%, which is called coinsurance.
So, in short: Deductible first, then Medicare pays most of it.

Tanja Roulhac · Answer

Physical therapy is covered under Medicare Part B, however you must first meet your deductible then benefits are paid. Medicare will pay 80% and the beneficiary is responsible for 20% of the approved cost.

Answered by Tanja Roulhac on April 8, 2025

Broker Licensed in FL, AZ, CA & 7 other states

Answered by Tanja Roulhac Medicare Insurance Agent

Dennis Sullivan · Answer

This is all dependent on the plan your'e on. This is a tough question to answer, not knowing the specifics of the plan...

Rene Apack · Answer

The short answer to the question is the one that no one likes. " I depends."

It depends on the Medicare plan that you currently own. 

On the Medicare Advantage plan side, some plans have a deductible, but mainly, they have a copay that you and the insurance company pay.

Again, on the Medicare Supplement side, it depends on your own Medicare Supplement plan. Plan F has no deductible, whereas Plan G has an annual deductible of $257 for 2025, which is amortized over several doctor's visits, lab work, etc.

Best wishes,
Rene Apack
847-917-4870

Kip Nussbaum · Answer

If you are on Original Medicare only, then yes, you would have to meet your deductible first ($257 for 2025). Upon meeting your deductible, Medicare would cover 80% of the visit and you would be responsible for 20%.

If you are on Original Medicare with a supplemental plan, some plans cover the Part B deductible but most do not.

If you are on Medicare with and Advantage Plan (also called Part C), most plans simply have a copay for your visit. Some plans (a limited amount in my area) do have a medical deductible but like I said, most just have a set copay amount.

Ken Banks · Answer

Yes, you do need to meet your Part B deductible before Medicare begins covering your physical therapy costs. Once your deductible is met, Medicare will typically cover 80% of the approved cost for outpatient physical therapy, and you will be responsible for the remaining 20%. The Part B deductible for 2025 is $257. Medicare will only cover physical therapy that is deemed medically necessary.

Answered by Ken Banks on April 14, 2025

Broker Licensed in GA, AL, FL, LA, NC & SC

Answered by Ken Banks Medicare Insurance Agent

John Ward · Answer

Physical Therapy generally has a co-pay that your responsible for, amount depends on your plan. Your physician must order the therapy and number of visits allowed. If in doubt check your plan summary or call your insurance company in advance. Always be a self-advocate.

Answered by John Ward on July 14, 2025

Broker Licensed in TX, FL, GA, LA, NM & OK

Answered by John Ward Medicare Insurance Agent

I'm on Medicare Part B, and I'm wondering how my physical therapy visits are covered. Do I have to hit my deductible first?

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I'm on Medicare Part B, and I'm wondering how my physical therapy visits are covered. Do I have to hit my deductible first?

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