Physical Therapy Costs and Insurance Coverage
Physical therapy is covered by most health insurance plans.
- The average cost of physical therapy is $137 per one-hour session if you pay full price.
- With insurance, physical therapy costs about $40 per session. But costs can vary widely by plan.
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How much does physical therapy cost?
If you pay full price, physical therapy costs an average of $137 per session, or $1,370 for 10 sessions.
Cost of physical therapy
Full price | With insurance | |
---|---|---|
1-hour session | $137 | $40 |
5 sessions | $685 | $200 |
10 sessions | $1,370 | $400 |
30 sessions | $4,110 | $1,200 |
Costs with insurance are based on typical rates for a Silver plan after you've met the deductible.
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The typical cost of physical therapy with insurance is $40 per session or $400 for 10 sessions. How much you pay depends on your health insurance plan.
Your costs also depend on:
- How much you've already spent on health insurance this year: Many plans only cover physical therapy after you meet your plan's deductible. However, some plans will cover physical therapy before you reach your deductible. This can save you a lot of money when you only need some health care.
- The exact treatment you receive during your appointment: A physical therapy session usually includes several different types of exercises and treatments, which are usually billed in 15-minute increments. So if you have a plan where you pay a percentage of the session cost, your bill will change based on the treatment you receive and how long your appointment is.
Costs of physical therapy procedures
Physical therapy service | Full price |
---|---|
Treatments for strength and movement | |
Hands-on therapy | $27 |
Therapeutic exercises | $29 |
Walking therapy | $29 |
Neuromuscular training | $33 |
Treatments are often billed in 15-minute increments. Full prices shown here are typically for 15 minutes.
Is physical therapy covered by insurance?
Physical therapy is covered by most insurance plans because it's an "essential benefit" under the Affordable Care Act (ACA).
ACA plans must cover rehabilitative services. That means plans will cover physical therapy, occupational therapy, speech-language pathology and more. Physical therapy will be covered at different locations.
- A physical therapist office
- A hospital or if you're staying at a care facility
- Your home if you're unable to leave your house
However, to get insurance to pay for your physical therapy, you'll need to follow the plan's rules about which doctors you use, how many sessions you're allowed and when you need approval from your insurance company.
Cost of physical therapy with insurance
The cost of physical therapy with insurance depends on both your plan's benefits and which phase of coverage you're in.
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Phase 1: Before you meet your deductible: You usually pay the full cost of physical therapy.
Until you have enough medical costs to meet the plan's deductible, you'll pay the full price for most medical care. Depending on your plan, you could have to spend thousands of dollars before your plan's full benefits begin.
- You pay: Full amount of physical therapy (about $137 per hour)
- Insurance pays: $0
Phase 2: If you've met your deductible or don't need to meet a deductible: You'll split the cost of physical therapy with your insurance plan.
If your plan says the "deductible does not apply" to physical therapy, you'll only pay a portion of the physical therapy bill even if you haven't met your plan's deductible yet.
- You pay: The copay or coinsurance listed on your plan documents
- Insurance pays: The rest of the cost
The exact amount you pay depends on your plan's benefits and coverage tier. Usually, physical therapy and other medical care will cost less when you have a more expensive insurance plan. That's because it will pay for more of your bill.
Typical physical therapy copays and coinsurance
Plan tier | What you pay |
---|---|
Bronze | 45% of cost |
Silver | $40 copay |
Gold | $20 copay |
Insurance plans vary widely, and these copays and coinsurance are based on a sample of 2024 plans sold on the marketplace. Check your plan to find out how much you'll pay.
Phase 3: After you reach your plan's out-of-pocket max: You won't pay anything for physical therapy.
Each insurance plan has a cap on how much you'll have to pay for medical care. This can protect you from very high costs such as if you need expensive surgery. So if you've already spent enough on medical care to reach the out-of-pocket max, physical therapy will be free for the rest of the year until your new plan begins.
- You pay: $0
- Insurance pays: Full cost of physical therapy
Best insurance for physical therapy coverage
You'll get the best physical therapy benefits with an insurance plan that covers treatment before you meet your deductible.
This means that as soon as your plan begins, you'll only pay a small copay for physical therapy.
These plans can be a much better deal for physical therapy than a typical plan. For example, in a plan where physical therapy is only covered after you meet your deductible, you could have to spend thousands of dollars on medical care before your physical therapy costs go down.
Higher-tier insurance plans, such as Gold or Platinum, are more likely to cover physical therapy before your deductible. But the benefit is available across all tiers.
Best companies for physical therapy
Aetna and Blue Cross Blue Shield are the best insurance companies for physical therapy.
How to compare physical therapy insurance coverage
To find plans that cover physical therapy before the deductible, you'll need to look at the fine print for plans that say "deductible does not apply" next to that service.
This isn't always easy to find in the plan's materials, but your potential physical therapy savings can make it worth it.
For example, on the standard coverage sheet for HealthCare.gov plans, you have to scroll to Page 4 to see the physical therapy benefits with an Aetna Silver plan offered in Charlotte, N.C.
Does Medicare pay for physical therapy?
Yes, Medicare covers physical therapy when your doctor says it's necessary.
There is no limit on how much physical therapy Medicare will cover each year. That's because the cap was eliminated in 2018. However, you may need approval from Medicare either before you begin physical therapy or if you need more physical therapy appointments than is typical.
Does Medicaid cover physical therapy?
Physical therapy is covered by Medicaid in most states.
However, states can set their own rules about how Medicaid covers physical therapy. So where you live will determine your coverage.
For example, in Arizona, Medicaid will only cover 15 physical therapy appointments per year. But Michigan's Medicaid program initially covers up to 36 hours of physical therapy per year but will cover additional appointments with approval.
To find a physical therapist that accepts Medicaid:
- Start by getting a referral for physical therapy from your doctor.
- Check your Medicaid plan documents and the state coverage rules to see if you can go to any physical therapist or if only some physical therapists are covered.
- When you call to make your appointment, check that they'll accept Medicaid.
Frequently asked questions
Is physical therapy considered a specialist visit for insurance?
Physical therapy is covered by most insurance plans, but it's not considered a specialist visit. In your plan documents, physical therapy coverage is usually under "rehabilitation services" for treatment after an injury or illness. Your plan's documents may also have a row that specifically says physical therapy coverage.
What is the price of physical therapy?
The full price of a one-hour physical therapy appointment is typically $137 per session. Physical therapy prices are higher if you get physical therapy during a hospital stay or in your home if you can't leave the house.
Why is physical therapy so expensive?
Physical therapy can be very expensive if you get treatment at a hospital or if you use a physical therapist that's not in your plan's network. If you have insurance and go to a typical in-network physical therapist, you'll pay about $40 per hour. Without coverage, the average price is $137. The high cost is due to the physical therapist's years of training and certifications, as well as specialized equipment such as biofeedback devices.
Sources and methodology
The average cost of physical therapy uses the 2024 Medicare Physician Fee Schedule for the most popular physical therapy billing codes. Calculations are based on four services per hour since most treatments are billed in 15-minute increments.
Costs with insurance are based on a typical Silver plan, unless otherwise noted. Insurance coverage by company is based on 2024 marketplace plans sold on HealthCare.gov in Charlotte, N.C.
Editorial note: The content of this article is based on the author's opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.