Frequently asked questions about
Medicare coverage for physical therapy
I have difficulty arranging transportation to go to a therapy office on a regular basis. Does Medicare cover physical therapy in the home?
Yes. In-home Physical therapy is covered by Medicare part B.
Will there be any out of pocket expenses?
After you have satisfied your annual deductible, Medicare part B will cover 80% of the bill. If you have a supplemental insurance, it may cover part or all of the remaining 20%. Be sure to check with your supplemental carrier to understand the details of your coverage.
How many physical therapy visits can I receive?
You can receive physical therapy services for as long as it is medically necessary.
How does Medicare define medically necessary?
The definition for medical necessity can be found in National Government Services' policy document (called a local coverage determination). Simply put, there are two components to medical necessity (from NGS local coverage determination) :
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1. ... the patient’s condition has the potential to improve or is improving in response to therapy, maximum improvement is yet to be attained; and there is an expectation that the anticipated improvement is attainable in a reasonable and generally predictable period of time.
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2. The services shall be of such a level of complexity and sophistication or the condition of the patient shall be such that the services required can only be safely and effectively performed by a qualified clinician, or therapists supervising assistants.
Do I need a referral from my doctor to schedule physical therapy services?
The short answer is no. Medicare does not require a doctor's order. However, your doctor must sign a document we send him / her after your evaluation, called a certification / plan of care. New York State also allows physical therapists to evaluate and treat patients for up to 10 visits without a doctor's order.
However, our policy is to ask for a doctor's order before we start therapy to ensure that your doctor is aware that you are receiving physical therapy and has an opportunity to review and approve the plan of care.
How long are therapy sessions?
The length of a therapy session depends on a persons needs. Sessions typically are 30, 45 or 60 minutes, between 1-3 times per week, and are one-on-one with the therapist.
How do I schedule an appointment with Healthy at Home Physical Therapy?
There are several ways to schedule an appointment for physical therapy:
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1. Call us at 203-296-3448
2. Email us at hahpt@healthyathomept.com
3. Your doctor can fax a referral to 631-938-0769
4. You can click below to fill out our "request an appointment" form
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