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Medicare Physical Therapy

Renee Said:

i am disabled & have medicare. what equip. or physical therapy could i qualify for that medicare totally pays ?

We Answered:

How could anyone possibly answer this question? If completely depends on the nature of your disability. A person who can walk does not need a wheelchair, but medicare could pay for it if they could not.

They WILL pay for things required in the bathroom - this could include specialized shower chairs, transfer seats, lifts, supplies required to catheter or do bowel programs.

There are different Medicare programs and SOME have no co-pay.

Donald Said:

why does medicare waste so much money providing physical therapy for old coots who have nowhere to walk to ?

We Answered:

This is a stupid question. I hope you really dont feel this way about the issue. That would be sad

Nicole Said:

Will Medicare cover physical therapy not orderd by adoctor?

We Answered:

No they will not. But to be sure you should call CMS. Here is the phone number for Medi-Care questions
1-800-633-4227

I've been on Medi-Care for 7 years.

Dwayne Said:

Does Medicare cover Physical therapy on back problems? in Michigan?

We Answered:

We're in Virginia, not Michigan but I'm pretty certain that Medicare is the same everywhere you go. Medicare is very particular about what they cover, but as long as you find an in-network provider, they should partially reimburse you for your treatment. You can also see a chiropractor for that problem- that's a doctor of the spine and the vertebrae is what they specialize in. It might be worth your time to find a chiropractor in your area that also does physiological work (or even physical therapy itself) so you can get a well-rounded approach to feeling better. Any doctor's office you go to should be able to verify your benefits for you before you get seen. If you have any additional questions, you can call Medicare at the number written on the front of your Insurance Card and the people there are very friendly and will be able to help you out with specific benefit information. Hope your back feels better!

Daniel Said:

What is the required duration for treatment for Medicare Part A??

We Answered:

In what setting? Part A in a hospital is based on DRGs, meaning the hospital gets a set amount of money based on the patients diagnosis and any modifiers. They can be given therapy 3 times a day or none and the hospital will get the same amount of money. Therefore, there is no minimum or maximum. Patients now rarely get more than therapy once a day for 30 minutes in this setting.

In acute rehab, many regulations now exist about lenght of treatment. To qualify for acute rehab, the patient needs to be getting at least 3 hours of PT,OT, and/or speech which can be in individual or group settings. This equate to 12 units. A unit is roughly 15 minutes, although anything above 8 minutes counts as a unit.

I'm not as up to speed on skilled nursing facilities...the last time I checked, the were placed into RUGS...resource utilization groups, a way of assessing a patient to determine their needs which determines how much therapy they qualify for. This can be as little as a half hour a few times a week to 2 hours daily between multiple services.

...in the end, there is really no "bottom" number of minutes a patient need to be seen except in acute rehab

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