In-home physical therapy means a licensed therapist comes to your house to help you rebuild strength, balance and movement, usually after surgery, a fall, a stroke or a hospital stay. Medicare pays for it as part of home health care when you are homebound and a doctor orders it, and you pay nothing for covered home health services.
There is a second route that people mix up with the first. Part B outpatient therapy is a different Medicare benefit with different rules and a different cost. Most of the confusion about who pays comes from not knowing which route a provider is billing, so this guide starts there.
What in-home physical therapy is
Physical therapy at home is treatment in the place where you live, so the therapist can work on the stairs, the bathroom and the hallway you actually use. A visit usually has three parts: an assessment of how you move, exercises and hands-on treatment, and a plan for what you do between visits.
The providers on this page are Medicare-certified home health agencies that tell CMS they provide physical therapy. They are not private-practice therapists who happen to make house calls, and they are not home care agencies that send companions or personal care aides. If you want a private-practice therapist who comes to you, ask the practice directly whether it treats at home and how it bills.
Who in-home physical therapy helps
In-home therapy suits people who have trouble getting to a clinic or who need the therapist to see their home to treat them well. Common starting points are:
- A hospital discharge after a joint replacement, fracture or illness
- A fall, or a fear of falling, that has cut back daily activity
- A new weakness or balance problem after a stroke or other condition
- Long-standing mobility loss that makes leaving the house a major effort
This is a description of who uses the service, not advice on whether therapy is right for you. Your doctor decides that, and the therapist sets goals after an assessment.
What Medicare home health includes
When it is covered as home health, Medicare.gov says the care is part-time or intermittent skilled care. Physical therapy sits alongside skilled nursing, occupational therapy, speech-language pathology, medical social services and home health aide help. Aide help counts only when you also get skilled nursing or therapy.
Home health staff talk to your doctor or other provider about your care plan and keep them updated on your progress. Medicare.gov also says they should visit as often as your provider orders. If you qualify, you can get unlimited home health visits.
Medicare.gov lists what home health does not cover:
- 24-hour-a-day care at home
- Home meal delivery
- Homemaker services unrelated to your care plan
- Custodial or personal care, when that is the only care you need
You do not get a physical therapy visit and a daily bath aide from the same Medicare benefit. If you need hands-on help every day, read about home care and personal care, which are non-medical and paid for differently.
Home health or outpatient therapy
The two Medicare routes work differently.
| Home health | Outpatient (Part B) | |
|---|---|---|
| Who provides it | A Medicare-certified home health agency | A provider that takes Medicare |
| Who must order it | A doctor or other provider who has seen you in person | Your doctor or other qualified provider must certify you need it |
| Homebound required | Yes | Not stated on the Medicare.gov page |
| What you pay | Nothing for covered services | Part B deductible, then 20% of the Medicare-approved amount |
The Medicare.gov outpatient therapy page does not say where the visit can happen, and it does not address therapy at home. So if a private therapist provides home visits under Part B, ask exactly how they bill and what you will owe.
How it differs from home health and home care
- Home health care is the wider benefit that includes nursing and other therapies. In-home physical therapy is the therapy part of it. For the full comparison with non-medical help, read home health care vs home care.
- Home care is non-medical help with daily tasks. It is not ordered by a doctor and Medicare does not pay for it when it is the only care you need.
- Private duty nursing is longer shifts of nursing care for complex medical needs, not therapy.
- A nursing home or rehab stay, described under nursing homes, is the alternative when you cannot safely recover at home.
Who pays for physical therapy at home
Medicare. Under home health, you pay nothing for covered services. Medicare.gov says the agency should tell you, verbally and in writing, what Medicare will pay and what it will not. If Medicare will not cover an item or service, the agency should give you an Advance Beneficiary Notice before providing it. Under Part B outpatient therapy, you pay the Part B deductible ($283 in 2026), then 20% of the Medicare-approved amount. See what Medicare pays for for the wider rules.
Medicare Advantage and Medigap. Medicare.gov says to check with your plan if you have a Medicare Advantage Plan, and to tell your provider about any Medigap or other coverage so bills are paid correctly.
Medicaid. Medicaid.gov describes 1915(c) home and community-based services waivers as programs states design, covering a mix of medical and non-medical services. Each state chooses the services and the number of people it serves. Whether a waiver or your state plan pays for therapy at home depends on the state. See Medicaid and the state programs.
VA. VA lists skilled home health care through community agencies for Veterans who are homebound or live far from a VA facility, and home-based primary care delivered by a VA team. Eligibility needs VA health care enrollment and a VA determination of need. See VA benefits.
Private pay and long-term care insurance. If you do not meet the Medicare rules, you can pay out of pocket. Check long-term care insurance and private pay for how those work, and ask your insurer in writing whether therapy at home counts.
What drives what you pay for therapy
We do not quote average prices, because the sources we trust do not publish a national figure and prices vary by place. These are the factors that change what you pay:
- Which route pays: home health (no cost for covered services) or Part B (deductible plus 20%)
- Whether you meet the homebound test, which decides if home health applies
- The number and length of visits your provider orders
- Whether the agency or therapist is in your plan's network
- Services Medicare will not pay for, which the agency should list for you before care starts
Get the answer to "what will I owe?" in writing before the first visit.
How CMS rates home health agencies
Because these are Medicare-certified home health agencies, CMS publishes Home Health Star Ratings on Care Compare. There are two kinds:
- Quality of Patient Care. Based on OASIS assessments and Medicare claims data, using seven process and outcome measures. An agency needs at least 20 complete quality episodes for each measure and data on 5 of the 7 measures to get a rating.
- Patient Survey. Based on the Home Health CAHPS Survey. An agency needs 40 or more completed surveys over the four-quarter reporting period to get a star rating.
CMS updates both quarterly and says it expects the ratings to evolve over time. An agency with no stars may just be small or new, so a missing rating is a prompt to ask questions, not a verdict. Our care ratings by state research and methodology explain how we use CMS data.
How to choose a home therapy agency
- Confirm the agency is Medicare-certified, and ask which plans and Medicaid programs it accepts.
- Look up its Care Compare ratings and note which ratings are missing.
- Ask who provides the therapy and what licence they hold. Ask whether an assistant ever treats you and how the therapist supervises.
- Ask how soon the first visit happens after your doctor's order.
- Ask how the agency will update your doctor on progress.
- Ask for the coverage explanation in writing.
Questions to ask before the first visit
- How many visits a week do you expect, and for how many weeks?
- Will the same therapist see me each time?
- What home exercises will I be given, and who checks them?
- What happens if I miss a visit, or a visit has to be rescheduled?
- What will Medicare, my plan and I each pay, and when will I get a notice if something is not covered?
- Who do I call after hours if I am worried?
Red flags when choosing an agency
- An agency that asks you to pay for services Medicare says are covered as home health
- No written explanation of what is and is not covered, and no Advance Beneficiary Notice when something is excluded
- Refusing to say who will provide your therapy or what their licence is
- Pressure to sign up before your doctor has ordered care
- Promises of a fixed outcome or a fixed number of visits before you have been assessed
If you think an agency is billing wrongly, your first call is your plan or Medicare, not the agency.
About the agencies listed below
Carevo is a directory and connection platform. It does not provide therapy, assess whether you qualify for Medicare, or vouch for any agency. The lists below come from CMS data. Use get matched if you want help finding agencies near you, and check each agency yourself before you agree to care.