Does Medicare cover outpatient surgery and physical therapy?

Part B, which is the outpatient side of Medicare, covers a wide range of services you receive without being admitted to a hospital. Outpatient surgery performed at a hospital or ambulatory surgical center is covered. Physical therapy, occupational therapy, and speech-language pathology are covered as well. These have historically had caps on how much Medicare would pay in a year, but Congress permanently removed those caps, so medically necessary therapy is no longer cut off at an arbitrary dollar limit. The standard cost-sharing under Part B is 20% of the Medicare-approved amount, after you meet the annual Part B deductible. That 20% can add up, especially for a surgical procedure. If you have a Medicare Supplement plan, also called Medigap, it will typically cover some or all of that 20%. If you are on a Medicare Advantage plan, your cost-sharing will follow that plan's specific structure, which might be a copay per visit rather than a percentage. One thing to confirm before any procedure is whether the provider accepts Medicare assignment, meaning they agree to Medicare's approved rates. Providers who do not accept assignment can charge you more. Always verify current coverage details with Medicare or your plan directly.

Related Medicare Resources

• Medicare Advantage HMO Plans
• Medicare Advantage PPO Plans
• Medicare Supplement Plan G
• Compare Medicare Plans