Does Medicaid Cover Physical Therapy?
- Find out if Medicaid covers physical therapy sessions in your state. You can also discover whether copayment is required and if there are any service limitations.
Physical therapy can help with a wide range of ailments, from arthritis to stroke and traumatic brain injury. It can help restore function, relieve pain and improve mobility, reducing the need for medication and maintaining health and fitness. Physical therapists work in a variety of settings, including inpatient, outpatient and community-based health care centers.
Continue reading to discover whether your Medicaid insurance plan might cover the cost of physical therapy for you.
Learn More About Medicare
Join our email series to receive your free Medicare guide and the latest information about Medicare.
By clicking "Sign me up!" you are agreeing to receive emails from HelpAdvisor.com
Thanks for signing up!
Your free Medicare guide is on the way.
Make sure to check your spam folder if you don't see it.
Does Medicaid Cover Physical Therapy?
Medicaid benefits are governed on a state-by-state basis. Use the table below to find out about the coverage for physical therapy in your locale.
Note: Data is from 2018 and doesn't include coverage for medically needy citizens. Medically needy individuals should speak to their local Medicaid office to determine eligibility for physical therapy services.
|
State |
Who's Covered for Physical Therapy? |
Copayment Required? |
Service Limitations |
|
Alabama |
N/A |
N/A |
N/A |
|
Alaska |
N/A |
N/A |
N/A |
|
Arizona |
Categorically Needy |
Beneficiaries with Transitional Medical Assistance pay $3 per visit |
15 sessions each for habilitation and rehabilitation |
|
Arkansas |
Categorically Needy |
Unknown |
Unknown |
|
California |
Categorically Needy |
$1 per outpatient appointment |
Preventing hospitalization and rehab potential required |
|
Colorado |
Categorically Needy |
No |
No |
|
Connecticut |
N/A |
N/A |
N/A |
|
Delaware |
Categorically Needy |
No |
Services must be necessary and reasonable, renewed by a physician every 30 days and can take place at home or in-office. |
|
D.C. |
Categorically Needy |
No |
PA required for reimbursement |
|
Florida |
Categorically Needy |
No |
$1,500 per year maximum for outpatient physical therapy |
|
Georgia |
N/A |
N/A |
N/A |
|
Hawaii |
Categorically Needy |
No |
No |
|
Idaho |
Categorically Needy |
No |
No |
|
Illinois |
Not Released |
Not Released |
Not Released |
|
Indiana |
Categorically Needy |
No |
12 hours every 30 days or 30 therapy sessions per month, requires prior authorization unless ordered by a doctor before hospital discharge |
|
Iowa |
Not Released |
Not Released |
Not Released |
|
Kansas |
Categorically Needy |
$1 per service date |
Six consecutive months of therapy per illness or injury |
|
Kentucky |
Categorically Needy |
$3 |
Limit of 20 sessions per year |
|
Louisiana |
Categorically Needy |
No |
Prior authorization required |
|
Maine |
Categorically Needy |
50 cents to $2 per day, depending on amount, capped at $20 per month |
Only applicable to acute conditions with rehab potential, two hours per day |
|
Maryland |
Categorically Needy |
No |
No |
|
Massachusetts |
Categorically Needy |
No |
No |
|
Michigan |
Categorically Needy |
No |
144 units of service per year without PA |
|
Minnesota |
Categorically Needy |
Not Released |
No |
|
Mississippi |
Categorically Needy |
No |
Not Released |
|
Missouri |
N/A |
N/A |
N/A |
|
Montana |
Categorically Needy |
Income equal to or below 100% of federal poverty line = $4 per visit, above FPL = 10% of total amount |
No |
|
Nebraska |
Categorically Needy |
$1 per session for evaluation services |
60 sessions per fiscal year, including physical therapy, speech therapy and occupational therapy |
|
Nevada |
Not Released |
Not Released |
Not Released |
|
New Hampshire |
Categorically Needy |
No |
Not Released |
|
New Jersey |
Categorically Needy |
No |
No |
|
New Mexico |
Categorically Needy |
$7 for RDI beneficiaries |
No |
|
New York |
Not Released |
Not Released |
Not Released |
|
North Carolina |
Categorically Needy |
No |
Prior authorization required and sessions per year are limited |
|
North Dakota |
Categorically Needy |
$2 per session |
15 sessions and one evaluation per year |
|
Ohio |
Categorically Needy |
No |
30 sessions per year without PA |
|
Oklahoma |
Categorically Needy |
$4 per visit |
One evaluation or reevaluation per year; up to 15 sessions per calendar year in an outpatient setting |
|
Oregon |
Categorically Needy |
No |
Coverage based on priority list of services. Day limits apply. |
|
Pennsylvania |
N/A |
N/A |
N/A |
|
Rhode Island |
Categorically Needy |
No |
No |
|
South Carolina |
Not Released |
Not Released |
Not Released |
|
South Dakota |
Categorically Needy |
No |
Not Released |
|
Tennessee |
Categorically Needy |
No |
No |
|
Texas |
Categorically Needy |
No |
Prior authorization required |
|
Utah |
Categorically Needy |
$4 per session |
20 sessions a year, rehab potential required |
|
Vermont |
Categorically Needy |
No |
Physician order required, 30 sessions per year (including occupational and speech therapy), additional services require prior authorization |
|
Virginia |
Categorically Needy |
$3 per visit |
Not Released |
|
Washington |
Categorically Needy |
No |
12 units per year, but more with PA |
|
West Virginia |
Categorically Needy |
No |
20 sessions per calendar year, inclusive of occupational therapy |
|
Wisconsin |
Categorically Needy |
50 cents to $3 per session, no copay after whichever occurs first out of $1,500 or 30 hours of service per calendar year |
Prior authorization required after 35 sessions, excluding evaluations, sessions limited to 90 minutes per service date |
|
Wyoming |
Categorically Needy |
No |
Prior authorization required following initial 20 sessions to confirm medical necessity |
Does Medicaid Cover Physical Therapy at Home?
Each state is able to determine coverage, independent of the federal government. Some locations cover physical therapy at home in addition to in an inpatient or outpatient setting, but others don't. Speak to your local Medicaid office to find out whether the cost of home-based physical therapy is included in your insurance plan.
How Many Days of Physical Therapy Does Medicaid Cover?
Medicaid coverage varies significantly by state. For example, in Vermont, beneficiaries are covered for 30 therapy sessions per year, including occupational and speech therapy. In Kentucky, the limit is 20 sessions per year. Some states, such as New Jersey and New Mexico don't place any limitations on the number of days beneficiaries are entitled to receive physical therapy treatment.
