Does Medicare cover occupational therapy?

While physical therapy and occupational therapy overlap in some areas, they differ in several key ways. Physical therapists (PTs) help patients gain functional mobility — walking, transferring surface to surface — through specific exercises, while occupational therapists (OTs) help their patients regain or increase activities of daily living (ADLs). These activities may include bathing or eating independently, dressing, toileting, or participating in a favorite hobby. 

Occupational therapists help patients by practicing activities directly related to their goals to build skills, master the use of equipment, and/or function in a more accessible environment. For example, an occupational therapist may help a stroke patient by using adaptive equipment to partially support their arm while picking up a fork. These efforts can help them meet their eventual goal of eating independently.  

Occupational therapy patients may have cognitive impairments, limited mobility, debilitating conditions, and/or significant injuries. Occupational therapy services can occur in different settings, including outpatient clinics, hospitals, primary care offices, and patients’ homes. 

While independent living facilities cater to residents in good overall health and may not have such services readily available, seniors who need assistance performing routine tasks and reside in assisted living facilities, nursing homes, or memory care facilities can receive occupational therapy. 

Many seniors and their families may be concerned about costs and wonder, "Does Medicare cover occupational therapy?" Fortunately, Medicare occupational therapy coverage is available in several settings, making it an affordable option for many seniors.

Medicare Part A is Medicare's hospital insurance, and Medicare Part B is its medical insurance. Most older people sign up for Part A and Part B through Social Security. Combined coverage from both parts is referred to as "Original Medicare." 

Benefits under Original Medicare are managed by the federal government. Alternatively, individuals can receive Medicare Part A and B benefits (and often also Part D benefits) bundled in a single plan offered by a private company. These plans are referred to as "Medicare Advantage" and "Medicare Part C."

As a federal program, Original Medicare coverage is standardized with the same costs and benefits across the country. Original Medicare's Part A covers occupational therapy for a limited time when provided at home or in a skilled nursing facility. Meanwhile, Original Medicare's Part B covers reasonable and medically necessary occupational therapy services at 80% in an outpatient setting. The patient is responsible for the 20% deductible.

Medicare Advantage plans provide at least as much coverage as Original Medicare Part A and Part B and may offer additional benefits. Medicare Advantage costs vary depending on the plan.  

Important: Regardless of the rules regarding any particular type of care, for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

• The care must be "medically necessary," which means that it must be ordered or prescribed by a licensed physician or another authorized medical provider and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help with ensuring your coverage, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?
• The care must be performed or delivered by a healthcare provider who participates in Medicare.

Medicare Part A, or Medicare's hospital insurance, covers occupational therapy on a short-term basis in settings like your home or a skilled nursing facility. Eligibility criteria, coverage, and costs vary depending on the setting. 

Medicare Part A covers home health services for illness and injury, which may include occupational therapy. To qualify, you must also need part-time or intermittent skilled nursing services. You must also be considered homebound or have difficulty leaving your home. 

Coverage of skilled nursing care and home health aid services are limited to a combined 8 hours a day and up to 28 hours a week. Care for less than 8 hours a day but up to 35 hours per week is also an option Medicare allows, but only if deemed necessary by a healthcare provider. Costs for home health care services are fully covered. 

However, if the occupational therapy received in your home requires any medical equipment, you would pay 20% of the Medicare-approved amount for the equipment while Medicare pays the remaining 80%.

Medicare Part A covers occupational therapy for a limited time for inpatients in Medicare-certified skilled nursing facilities who require skilled care for an ongoing or new condition. 

However, for therapy to be covered at a skilled nursing facility, it must relate to meeting your health goals. You also need to be enrolled in Medicare Part A, have days left in the benefit period, and have undergone a qualifying inpatient hospital stay within a short time of entering the skilled nursing facility. 

Medicare determines costs for your inpatient stay based on its benefit periods, which begin the day you are admitted to the skilled nursing facility and end when you no longer receive care for 60 consecutive days. Beneficiaries have an unlimited number of benefit periods. 

An inpatient hospital deductible of $1,676 is due at the beginning of each benefit period. The first 20 days of each benefit period do not require copayments.

Under Original Medicare, skilled nursing facility stays don’t have a copayment for the first 20 days of the stay. Under Medicare Advantage, patients may pay a copayment for Days 1-20.  Patients must pay a copayment of $209.50 each day for the next 80 days, however. Medicare does not cover costs for days 101 and beyond, thereby requiring the patient to make any further payments.

Medicare Part B, or Medicare's medical insurance, covers occupational therapy on an outpatient basis if it's medically necessary and performed by a qualified therapist. To meet Medicare's requirements, a health provider like a nurse practitioner or physician assistant must have certified the therapy is necessary. 

Costs for receiving occupational therapy under Medicare Part B include meeting Part B's annual deductible of $257 and paying 20% of the Medicare-approved amount for the therapy. Medicare covers the other 80%. There is no limit to how much occupational therapy Medicare will pay for each year as long as it meets all of its coverage requirements. 

Variables that may affect your final costs include whether you also have other insurance and where services were provided. Remember: if a doctor is not a part of Medicare and/or does not agree to accept the assignment, you may have to cover all costs yourself.

Plans that are a part of Medicare Part C are known as Medicare Advantage plans and are required to provide at least as much coverage as Original Medicare Parts A and B. Occupational therapy will be covered on an outpatient basis and for a limited time when provided through home health services or at a skilled nursing facility. Some Medicare Advantage Plans may also provide additional benefits to their members that are not covered by Original Medicare Part A and B. 

Costs may also be different than they are for those with Original Medicare or for those with different Medicare Advantage policies. For example, unlike people with Original Medicare, you may be required to pay copayments during the first 20 days of a stay in a skilled nursing facility. Make sure you find out the specific benefits, limitations, and associated costs of your policy. 

You must meet all eligibility criteria to receive Medicare occupational therapy benefits, whether under Original Medicare or Medicare Advantage plans. While there is no limit to how much occupational therapy Medicare will cover when received on an outpatient basis under Original Medicare Part B, coverage is limited under Original Medicare Part A regardless of the setting. 

As a part of home health services, coverage must adhere to Medicare's hourly limits. Medicare caps skilled nursing facility coverage at 100 days per benefit period. If a doctor recommends more than is covered, you may have to pay some or all of the costs. You may also be responsible for costs for occupational therapy beyond the limits set by your Medicare Advantage policy.  

Seniors wondering, "Does Medicare cover occupational therapy?" or "Is occupational therapy covered by insurance?" will be relieved to learn that Original Medicare and Medicare Advantage plans cover OT at home, in skilled nursing facilities, and on an outpatient basis in other settings.  Original Medicare occupational therapy coverage is unlimited in outpatient settings under Original Medicare Part B but must fall within hourly or daily limits when a part of home health care or skilled nursing care services under Original Medicare Part B. Medicare Advantage plans must offer at least as much coverage as Original Medicare and may even have additional benefits but also have varying costs depending on the plan.

• Does Medicare cover occupational therapy? (n.d.). UnitedHealthcare
• Home health services. (n.d.). Medicare.gov
• Occupational therapy services. (n.d.). Medicare.gov
• Physical therapy services. (n.d.). 
• Skilled nursing facility care. (n.d.). Medicare.gov
• Therapy services. (2025). Centers for Medicare & Medicaid Services
• What does Medicare cost? (n.d.). Medicare.gov