Medicare Information

Rehab Associates participates with the Medicare program.  Medicare helps pay for medically necessary outpatient physical therapy when you have a referral from your physician for physical therapy services.  On your first visit, your therapist will evaluate you and develop a plan for your treatment.  This plan of care will be sent to your physician.  Your therapist will periodically provide updates to your physician on your progress and length of treatment required.

Medicare limits how much it will pay for outpatient physical therapy services per year.  This is called an annual financial limitation or cap.  Your Medicare benefit for outpatient physical therapy and speech-language pathology services combined is limited to $1,870 in 2011.  If the amount of treatment you require will exceed the amount covered, your physical therapist will talk with you about your options.  Often, patients have complicating factors that extend their recovery and require additional physical therapy.  If that is the case, your physical therapist can request an extension of the cap to ensure that you get the treatment that you need.  The therapy cap does not apply to services received within a hospital outpatient therapy department.

Medicare Part B pays for Physical Therapy as long as it is medically necessary up to the yearly benefit limit outlined above.  Medicare will pay for 80% of the Medicare-approved amount for all covered services.  You will be responsible for the remaining 20% of the Medicare-approved amount after you have met your annual deductible.  The annual deductible for Medicare Part B is $162 in 2011.  You must pay this amount before Medicare will begin to pay the 80% for covered services.

If you have a supplemental insurance plan in addition to Medicare, it may cover your deductible as well as the 20% that it your responsibility.

Our receptionists and/or billing staff will be happy to answer any specific questions that you have about your Medicare coverage.