Occupational therapy services

Medicare Part B (Medical Insurance) helps pay for medically necessary outpatient occupational therapy if your doctor or other health care provider (including a nurse practitioner, clinical nurse specialist, or physician assistant) certifies you need it.

Your costs in Original Medicare

After you meet the  Part B deductible , you pay 20% of the Medicare-approved amount

There's no limit on how much Medicare pays for your medically necessary outpatient therapy services in one calendar year.

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

Note

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if, or how much, Medicare will pay for them.

 

What it is

Therapy to help you perform activities of daily living (like dressing or bathing). This therapy helps to maintain current capabilities or slow decline.

Is my test, item, or service covered?