Physical therapy is an integral part of the treatment plan of most diseases. The patients may need physical therapy during the recovery phase following an injury or accident. He may also require this therapy for faster rehabilitation after a debilitating illness.
If your doctor has advised you to undergo physical therapy by your preferred home care agency in New York or the city are staying in, I am sure you would like to check if the costs would be covered by Medicare or other insurance plans. If yes, read further to learn whether your insurance plan covers physical therapy.
Understanding the Payments for Physical Therapy Services
Physical therapy refers to the healthcare services offered in order to improve the mobility of the patient. Physical therapists are the expert healthcare professionals licensed by the state where they practice.
Most insurance agencies provide coverage for physical therapy only when the therapist is licensed. Hence, if you are staying in Brooklyn or nearby cities, you can contact your local preferred home care agency in Brooklyn, NY
, to find whether the therapist provided by them is licensed.
Alternatively, you can check with the concerned authorities in your state that oversee physical therapy licensure to make sure the physical therapist assigned to you by your preferred home care agency in New York
is licensed. This is the basic requirement that must be fulfilled in order to receive reimbursement for the costs of physical therapy at home.
Here are the common concerns pertaining to the insurance coverage and reimbursement for physical therapy.
Does Medicare cover physical therapy?
Generally, Medicare covers the costs of physical therapies performed at home when they are considered medically necessary to ensure the recovery of the patient. The benefits may also include the coverage for other therapies deemed medically essential such as occupational therapies and speech-language therapy.
Your doctor may recommend a specific or a combination of different types of physical therapies based on the extent of your immobility and other symptoms.
Medicare coverage for physical, speech and occupational therapies would also depend on where you receive them.
Usually, Medicare Part B covers physical therapy. When you receive the sessions of physical therapy at a hospital or in a registered physician's office, 80% of the allowable charges will be covered by Medicare Part B.
The sessions performed at an outpatient center are also eligible for a similar 80% coverage of the costs. However, you will be considered eligible only if you have met the Part B deductible.
In most cases, patients prefer to receive physical therapy sessions at home. Hence, most patients are interested in finding out whether Medicare covers physical therapy received at home. Let’s check…
Does Medicare cover physical therapy at home?
Medicare Part A and Part B cover the costs of allowable inclusions when physical therapy services are received at home. In order to receive complete coverage for the physical therapy at home, you must fulfill the following criteria:
• Physical therapy is performed by a qualified therapist licensed by the state in which he practices, as discussed earlier. You can contact the local preferred home care agency in Brooklyn, NY
, supposing you are located in this region, to check whether they offer physical therapy services at home by a therapist licensed by Medicare.
• You must be certified homebound by a registered healthcare practitioner
• You must be under the care of a healthcare providerand the physical therapy should be a part of the comprehensive treatment plan that is regularly reviewed by the doctor.
• Your physician has recommended that the condition you are suffering from is expected to improve with regular physical therapy sessions or the therapy is needed to maintain a stable health condition and prevent any complications.
• The preferred home care agency in NewYorkor
the city you are located in providing the services must be certified by Medicare.
You will be eligible for Medicare coverage if all these conditions are fulfilled. If qualified for physical therapy services at home, you will have to pay 20% of the costs of medical equipment needed for the sessions, if it is recommended by the physician as a part of the treatment plan.
It is important to note that physical therapy at home is not covered by Medicare when is it part-time or intermittent in nature.
Points to remember…
There is no specific upper limit on the amount covered by Medicare for physical therapiesin a given calendar year. However, your physician will need to provide extra information in case the cost exceeds a certain amount. He should specify why the services are medically necessary for the patient to recover or avoid complications in order to continue receiving Medicare coverage benefits.
What are the other insurance options for physical therapy at home?
If you have signed up for a Medicare Advantage plan, you may receive extra coverage that would be in addition to the coverage offered by Part A and Part B of Medicare.
Most other insurance plans including workers’ compensation pay for physical therapy services when it is considered medically necessary and provided by or under the supervision of a physical therapist. It is advisable to check the reviews of preferred home care
agencies and insurance policies you plan to subscribe to get an idea of the quality of services and support offered by them.
The Bottom Line
Physical therapy can help restore the strength and mobility of the joints and muscles and thus, help reduce the recovery period after an illness. You can receive physical therapy at home by an expert therapist from your preferred home care agency in Brooklyn, NY
, or the city you are residing in. The costs of these therapies would be reimbursed by Medicare and other insurance plans provided the conditions discussed above are fulfilled.
The services of an expert physical therapist would help you recover from the state of limited or complete immobilization and allow you to get going with your routine life in a shorter duration.