Which statement best reflects Medicare coverage for physical therapy?

Which statement best reflects Medicare coverage for physical therapy?

• A. Medicare will pay for a patient's physical therapy
• B. Medicare will only pay for spinal adjustments
• C. Medicare pays for PT only if prescribed
• D. Medicare does not cover any therapy services

Answer: (B)

Medicare coverage for physical therapy hinges on medical necessity and an official order. In outpatient care, physical therapy is covered when a physician or qualified clinician prescribes it and a written plan of care is established and followed. Inpatient physical therapy is covered under Part A when there’s a qualifying hospital stay and appropriate documentation. Spinal adjustments done by chiropractors are not the same as physical therapy, so Medicare coverage isn’t based on them. The key point is that therapy services require a prescription and a documented plan of care to be covered.

Medicare coverage for physical therapy hinges on medical necessity and an official order. In outpatient care, physical therapy is covered when a physician or qualified clinician prescribes it and a written plan of care is established and followed. Inpatient physical therapy is covered under Part A when there’s a qualifying hospital stay and appropriate documentation. Spinal adjustments done by chiropractors are not the same as physical therapy, so Medicare coverage isn’t based on them. The key point is that therapy services require a prescription and a documented plan of care to be covered.