Does Medicare cover massage therapy, physical trainer and physical therapy?

8 answers | Last updated: Nov 26, 2016
John1 asked...

I have been diagnosed with Parkinson's. Does Medicare cover massage therapy, physical trainer and physical therapy?



Community Answers

John1 answered...
I don't know who to contact

A fellow caregiver answered...

Medicare Part B can cover outpatient physical therapy, occupational therapy, and speech therapy as prescribed by your doctor. Neither a physical trainer nor a massage therapist is covered by Medicare, but similar services may be part of what's provided by a physical therapist who's experienced with Parkinson's patients.

Although Medicare Part B "covers" physical therapy, that doesn't mean it pays the entire cost. For any session of physical or other therapy, Medicare pays 80 percent of the total amount it approves for those services. You must pay the other 20 percent out of your own pocket, unless you have a Medigap supplemental insurance policy that covers physical therapy. Also, if you haven't already paid the general yearly Part B deductible of $135, you have to pay that out of your pocket before Medicare will pay for any therapy.

There are also yearly limits on the total amount Medicare will pay for covered therapy[medicare.gov]. In 2008, Medicare Part B will pay its share only up to total bills of $1,810 for physical and speech therapy combined, and up to another total of $1,810 for occupational therapy bills.

Once you reach these yearly limits, there are still two ways you might get Medicare to pay for more therapy. The first is to ask your doctor and physical therapist to request that Medicare grant an "exception," if the doctor and therapist believe that your condition makes additional therapy "medically necessary." You don't have to do anything except ask them to make the request for you.

The other way to get Medicare to pay for additional therapy is to get the therapy from a hospital outpatient department.There's no yearly limit on Medicare payments for medically-necessary, physician-prescribed outpatient therapy services if you get them in a hospital outpatient department. On the other hand, a hospital outpatient department can charge you more than the Medicare-approved amount for its services, so that you'd personally owe not only 20 percent of the Medicare-approved total amount but also any amounts over that total.

Editor's Note: The coverage described above may have changed. For the most recent information, please check Medicare.gov's page about physical therapy and occupational therapy[medicare.gov].


Marciamspt answered...

One quick side note is that if you are homebound meaning it is unsafe for you to go places and/or it takes a taxing effort to get out and about, you can also have your doctor write you an order for home health physical therapy which is covered 100% by Medicare.

There are, of course, criteria for this... the first being the home bound issue. You will have also need to have a skilled need. That is a need that only a professional can assist you with. This need should be teachable to you or others to reach goals.

Home health care is not a long term solution but a short term one. Having said that, though, you may receive home health care as many times as you need it pending that an agency will take your case and your physician has written an order for it.

Good luck!

Marcia Oliver MSPT, CPT


A fellow caregiver answered...

Three is now new procedures for chronic conditions under Medicare , I do not know what is covered or not. Go to the government Medicare web site and rea dit for yourself. For the new coverage standards go to AARP they have many articles on this court case that has been won on. Federal court and it's implications. Pthe ruling is in effect even before the new guidebooks are written.If you go to AARP Facebook page you can read what was posted on Thursday and it will give you links to all the information they have


Dianajmc answered...

I read that Medicare pays 100% of in home massages, for us folks that can't get to office's, do to physical problems, or mental problems, I have both. Therefore, I'm very tense and locked up. I'm gonna get me one. Diana


Hwyfuzz answered...

Depending on the office - received massage therapy - the doctor that I went to had a massage therapist in his office and it was part of my therapy. So the answer from someone that had it - is yes!


A fellow caregiver answered...

I just looked it up on the Medicare page and it says,

"Massage therapy

How often is it covered?

Medicare doesn't cover massage therapy."


Painintheneck answered...

I KNOW FOR A FACT THAT MEDICARE DOES COVER MASSAGE THERAPY..I RECEIVED MASSAGE THERAPY FOR OVER THREE YEARS AT THE CENTER FOR INTERGRATIVE MEDICINE AT JEFFERSON UNIVERSITY HOSPITAL PHILADELPHIA PA....YOU HAVE TO GO THREE TIMES PER WEEK FOR THREE WEEKS....IT COVERS A CERTAIN AMOUNT OF SCHEDULED SESSIONS...IT DOES PAY...THE PROBLEM IS FINDING A PLACE OTHER THAN THAT ONE THAT WILL BILL THE INSURANCE COMPANY....