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Medicare Part B covers physical therapy (PT), speech-language pathology (SLP), and occupational therapy (OT). Previously, Medicare limited the amount of coverage you could get for therapy services in any given year as an outpatient or in a hospital outpatient department or emergency room, known as the therapy cap; however, in 2019, Medicare removed the cap, covering outpatient therapy at 80 percent of the Medicare-approved amount. When you receive services from a participating provider, you pay a 20 percent co-pay after you meet your Part B deductible, which in 2020 is $198.

These dollar limits are the total cost of the services received in a year — including what Medicare pays (80 percent of the Medicare-approved amount) and what you pay (20 percent). Medicare may continue to cover these services beyond the annual limits if you have a condition that requires ongoing therapy, such as extensive rehabilitation for stroke or heart disease. To get this exception, your therapist must justify the need when she bills Medicare. If the total cost reaches $3,000 in a year, Medicare automatically reviews your case.

For specific information, see the publication “Medicare Coverage of Therapy Services” at www.medicare.gov/Pubs/pdf/10988-Medicare-Limits-Therapy-Services.pdf.