Does Medicare Cover Physical Therapy? Part B and Advantage

Last updated: October 3, 2026

Quick Answer

Yes. Medicare Part B helps pay for medically necessary outpatient physical therapy, with no yearly limit, when a doctor or other qualified provider certifies that you need it. After the Part B deductible ($283 in 2026), you usually pay 20% of the Medicare-approved amount. Medicare Advantage plans cover physical therapy too, but may require a referral or prior authorization and charge their own copays. At our Miami Gardens clinic we accept Medicare Part B and Medicare Advantage plans from Aetna (HMO), AvMed, CarePlus, Devoted Health, Florida Complete Care, Preferred Care Partners and Solis Health. We do not accept Medicaid.

Original Medicare (Part B): what is covered

According to Medicare.gov, Part B covers outpatient physical therapy to restore or improve movement after an injury, illness or surgery, and also to maintain your current function or slow decline. Examples include rehab after a knee or hip replacement, back and neck pain, balance problems and weakness after a hospital stay.

• Certification: a doctor, nurse practitioner, clinical nurse specialist or physician assistant must certify your plan of care.
• No yearly cap: there is no limit on how much Medicare pays for medically necessary outpatient therapy in a year.
• Documentation threshold: after $2,480 in physical and speech therapy combined (2026), your therapist adds a code (the KX modifier) to confirm care is still medically necessary. It is a checkpoint, not a cap.

What you pay with Original Medicare

• The yearly Part B deductible: $283 in 2026.
• Usually 20% of the Medicare-approved amount for each visit after that.
• A Medicare Supplement (Medigap) plan may pay some or all of the 20%.

We do not quote a set price here because the approved amount depends on the services in each visit. We verify your benefits before you start.

Medicare Advantage: what to check

Medicare Advantage (Part C) plans must cover what Original Medicare covers, but each plan sets its own rules:

• Network: HMO plans usually require in-network providers.
• Referral and authorization: many plans need a referral from your primary care doctor and approval for a set number of visits.
• Copay: often a fixed amount per visit instead of 20%.

Medicare plans we accept in Miami Gardens

For physical therapy, we accept Medicare Part B and these Medicare Advantage plans: Aetna (HMO), AvMed, CarePlus, Devoted Health, Florida Complete Care, Preferred Care Partners and Solis Health. Accepting a carrier does not mean every plan it sells is in network, so we check your specific plan. See the full list on our insurance page.

We do not accept Medicaid, including Florida Medicaid managed-care plans.

Physical therapy near Miami Gardens, Miami Lakes and Hialeah

Our clinic is at 16191 NW 57 Ave, Suite A, Miami Gardens, FL 33014, on NW 57 Ave. Physical therapy is provided by Patricia Freire, PT, in English and Spanish. Patients come from Miami Gardens, Miami Lakes, Country Club and Hialeah. Learn more about physical therapy in Miami Gardens and Medicare physical therapy.

Hours: Monday, Wednesday and Friday 8:00 AM–5:00 PM; Tuesday and Thursday 8:00 AM–3:00 PM. We are a different clinic from All In One Care Solutions, which is in the same building.

How to get started

1. Call (786) 613-7160 with your Medicare or Medicare Advantage card.
2. We check your plan, any referral or authorization it requires, and your deductible.
3. Bring your card, a photo ID, any referral or prescription, and a list of medicines to your first visit.

Frequently Asked Questions

Does Medicare cover physical therapy?
Yes. Medicare Part B helps pay for medically necessary outpatient physical therapy when a doctor, nurse practitioner, clinical nurse specialist or physician assistant certifies that you need it. After the Part B deductible, you usually pay 20% of the Medicare-approved amount.

Is there a limit on physical therapy visits with Medicare?
There is no yearly limit on medically necessary outpatient therapy under Original Medicare. Above a yearly amount ($2,480 for physical and speech therapy combined in 2026), the therapist must confirm on the claim that care is still medically necessary. Medicare Advantage plans may require authorization for visits.

How much will I pay for physical therapy with Medicare?
With Original Medicare you pay the Part B deductible ($283 in 2026), then usually 20% of the Medicare-approved amount. A Medigap plan may cover some or all of that 20%. Medicare Advantage plans set their own copays. We verify your benefits before your first visit.

Which Medicare Advantage plans do you accept for physical therapy?
We accept Medicare Part B and these Medicare Advantage plans: Aetna (HMO), AvMed, CarePlus, Devoted Health, Florida Complete Care, Preferred Care Partners and Solis Health. Coverage depends on your specific plan, so call (786) 613-7160 with your member ID.

Do you accept Medicaid?
No. All In One Specialty Health does not accept Medicaid, including Florida Medicaid managed-care plans.

Sources

• Medicare.gov: Physical therapy services
• CMS: Therapy Services (2026 KX modifier threshold)
• Medicare.gov: Your Medicare Benefits (2026 Part B deductible)

This article is general information, not a guarantee of coverage or payment. Your plan's rules decide what is covered. Call (786) 613-7160 to verify your benefits.