Coverage for Medicare In-Home Therapy Services

If you have coverage under Medicare, in-home therapy services are available!

Medically-necessary therapy services are partially paid for by Medicare Part B Insurance and Original Medicare. If you’re homebound, they will pay for an approved Medicare in-home therapist to provide therapy to you at home. 

In-home physical therapy, occupational therapy and speech / language pathology are all partially covered under Medicare. However, there are limits on services called “therapy caps”.

In 2014, the Therapy Caps are:

  • $1,920 for physical therapy (PT) and speech-language pathology (SLP) services combined
  • $1,920 for occupational therapy (OT) services

Medicare In-Home Therapy Services, In-Home Physical Therapy, Occupational Therapy, Speech and Language TherapyIf your therapist documents your need for medically-necessary services, you may qualify for an exception to the limits. Speak to him or her directly and ask them to do the proper paperwork as part of your medical records. Before performing services that aren’t medically necessary, the Therapist must also provide you with an written notice called an Advance Beneficiary Notice of Noncoverage (ABN).

You may incur costs for deductible and co-insurance. In Original Medicare, you pay 20% of the Medicare-approved amount, and the Part B deductible applies. The Plan covers in-home therapy, outpatient hospital departments, private practices, rehab agencies and facilities and skilled nursing facilities.

Read more about Medicare Therapy Coverage on the Official Website >

Medicare covers many types of in-home medical services, such as skilled nursing and home health aides, if you are homebound and you need more than intermittent nursing care. Read more about their guidelines on the Official Home Health Services page of the Medicare Website. 

To find out if a specific home-care service is covered by your Medicare Plan, contact your healthcare provider or call Comprehensive Home Healthcare. We can help you navigate the Medicare system for therapy while getting you the quality therapy you need to get well!